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Rodó X, Bouma MJ, Rodríguez-Arias MÀ, Roy M, De Yebra P, Petrova D, García-Díez M, Pascual M. Strain variation and anomalous climate synergistically influence cholera pandemics. PLoS Negl Trop Dis 2024; 18:e0012275. [PMID: 39088420 PMCID: PMC11293675 DOI: 10.1371/journal.pntd.0012275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/06/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND Explanations for the genesis and propagation of cholera pandemics since 1817 have remained elusive. Evolutionary pathogen change is presumed to have been a dominant factor behind the 7th "El Tor" pandemic, but little is known to support this hypothesis for preceding pandemics. The role of anomalous climate in facilitating strain replacements has never been assessed. The question is of relevance to guide the understanding of infectious disease emergence today and in the context of climate change. METHODOLOGY/PRINCIPAL FINDINGS We investigate the roles of climate and putative strain variation for the 6th cholera pandemic (1899-1923) using newly assembled historical records for climate variables and cholera deaths in provinces of former British India. We compare this historical pandemic with the 7th (El Tor) one and with the temporary emergence of the O139 strain in Bangladesh and globally. With statistical methods for nonlinear time series analysis, we examine the regional synchrony of outbreaks and associations of the disease with regional temperature and rainfall, and with the El Niño Southern Oscillation (ENSO). To establish future expectations and evaluate climate anomalies accompanying historical strain replacements, climate projections are generated with multi-model climate simulations for different 50-year periods. The 6th cholera pandemic featured the striking synchronisation of cholera outbreaks over Bengal during the El Niño event of 1904-07, following the invasion of the Bombay Presidency with a delay of a few years. Accompanying anomalous weather conditions are similar to those related to ENSO during strain replacements and pandemic expansions into Africa and South America in the late 20th century. Rainfall anomalies of 1904-05 at the beginning of the large cholera anomaly fall in the 99th percentile of simulated changes for the regional climate. CONCLUSIONS/SIGNIFICANCE Evolutionary pathogen change can act synergistically with climatic conditions in the emergence and propagation of cholera strains. Increased climate variability and extremes under global warming provide windows of opportunity for emerging pathogens.
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Affiliation(s)
- Xavier Rodó
- ICREA, Barcelona, Spain
- CLIMA (Climate & Health) Group, ISGlobal, Barcelona, Spain
| | | | | | - Manojit Roy
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Pau De Yebra
- Department of Experimental Limnology, Leibniz Institute of Freshwater Ecology and Inland Fisheries, Stechlin, Germany
- Department of Wildlife Diseases, Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
| | | | | | - Mercedes Pascual
- Department of Biology and Department of Environmental Sciences, New York University, New York City, New York, United States of America
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Bitew A, Gelaw A, Wondimeneh Y, Ayenew Z, Getie M, Tafere W, Gebre-Eyesus T, Yimer M, Beyene GT, Bitew M, Abayneh T, Abebe M, Mihret A, Yeshitela B, Teferi M, Gelaw B. Prevalence and antimicrobial susceptibility pattern of Vibrio cholerae isolates from cholera outbreak sites in Ethiopia. BMC Public Health 2024; 24:2071. [PMID: 39085873 PMCID: PMC11292863 DOI: 10.1186/s12889-024-19621-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 07/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Cholera is an acute infectious disease caused by ingestion of contaminated food or water with Vibrio cholerae. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. The aim of this study was to assess the prevalence and antimicrobial susceptibility pattern of V. cholerae from cholera outbreak sites in Ethiopia. METHODS Across-sectional study was conducted from May 2022 to October 2023 across different regions in Ethiopia: Oromia National Regional State, Amhara National Regional State and Addis Ababa City Administration. A total of 415 fecal samples were collected from the three regions. Two milliliter fecal samples were collected from each study participants. The collected samples were cultured on Blood Agar, MacConkey Agar and Thiosulfate Citrate Bile Salt Sucrose Agar. A series of biochemical tests Oxidase test, String test, Motility, Indole, Citrate, Gas production, H2S production, Urease test were used to identify V. cholerae species. Both polyvalent and monovalent antisera were used for agglutination tests to identify and differentiate V. cholerae serogroup and serotypes. In addition, Kirby-Bauer Disk diffusion antibiotic susceptibility test method was done. Data were registered in epi-enfo version 7 and analyzed by Statistical Package for Social Science version 25. Descriptive statistics were used to determine the prevalence of Vibrio cholerae. Logistic regression model was fitted and p-value < 0.05 was considered as statically significant. RESULTS The prevalence of V. cholerae in the fecal samples was 30.1%. Majority of the isolates were from Oromia National Regional State 43.2% (n = 54) followed by Amhara National Regional State 31.2% (n = 39) and Addis Ababa City Administration 25.6% (n = 32). Most of the V. cholerae isolates were O1 serogroups 90.4% (n = 113) and Ogawa serotypes 86.4% (n = 108). Majority of the isolates were susceptible to ciprofloxacin 100% (n = 125), tetracycline 72% (n = 90) and gentamycin 68% (n = 85). More than half of the isolates were resistant to trimethoprim-sulfamethoxazole 62.4% (n = 78) and ampicillin 56.8% (n = 71). In this study, participants unable to read and write were about four times more at risk for V. cholerae infection (AOR: 3.8, 95% CI: 1.07-13.33). In addition, consumption of river water were about three times more at risk for V. cholerae infection (AOR: 2.8, 95% CI: 1.08-7.08). CONCLUSION our study revealed a high prevalence of V. cholerae from fecal samples. The predominant serogroups and serotypes were O1 and Ogawa, respectively. Fortunately, the isolates showed susceptible to most tested antibiotics. Drinking water from river were the identified associated risk factor for V. cholerae infection. Protecting the community from drinking of river water and provision of safe and treated water could reduce cholera outbreaks in the study areas.
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Affiliation(s)
- Abebaw Bitew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
- Department of Medical Microbiology, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Aschalew Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yitayih Wondimeneh
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zeleke Ayenew
- Department of Bacteriology, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Michael Getie
- Department of Medical Microbiology, Amhara National Regional State Public Health Institute, Bahir Dar, Ethiopia
| | - Wudu Tafere
- Department of Medical Microbiology, Amhara National Regional State Public Health Institute, Bahir Dar, Ethiopia
| | - Tsehaynesh Gebre-Eyesus
- Department of Medical Microbiology, Amhara National Regional State Public Health Institute, Bahir Dar, Ethiopia
| | - Marechign Yimer
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Getachew Tesfaye Beyene
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Molalegne Bitew
- Bio and Emerging Technology Institute of Ethiopia, Addis Ababa, Ethiopia
| | | | - Markos Abebe
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Adane Mihret
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Biruk Yeshitela
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mekonnen Teferi
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Baye Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chaguza C, Chibwe I, Chaima D, Musicha P, Ndeketa L, Kasambara W, Mhango C, Mseka UL, Bitilinyu-Bangoh J, Mvula B, Kipandula W, Bonongwe P, Munthali RJ, Ngwira S, Mwendera CA, Kalizang'oma A, Jambo KC, Kambalame D, Kamng'ona AW, Steele AD, Chauma-Mwale A, Hungerford D, Kagoli M, Nyaga MM, Dube Q, French N, Msefula CL, Cunliffe NA, Jere KC. Genomic insights into the 2022-2023Vibrio cholerae outbreak in Malawi. Nat Commun 2024; 15:6291. [PMID: 39060226 PMCID: PMC11282309 DOI: 10.1038/s41467-024-50484-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Malawi experienced its deadliest Vibrio cholerae (Vc) outbreak following devastating cyclones, with >58,000 cases and >1700 deaths reported between March 2022 and May 2023. Here, we use population genomics to investigate the attributes and origin of the Malawi 2022-2023 Vc outbreak isolates. Our results demonstrate the predominance of ST69 clone, also known as the seventh cholera pandemic El Tor (7PET) lineage, expressing O1 Ogawa (~ 80%) serotype followed by Inaba (~ 16%) and sporadic non-O1/non-7PET serogroups (~ 4%). Phylogenetic reconstruction revealed that the Malawi outbreak strains correspond to a recent importation from Asia into Africa (sublineage AFR15). These isolates harboured known antimicrobial resistance and virulence elements, notably the ICEGEN/ICEVchHai1/ICEVchind5 SXT/R391-like integrative conjugative elements and a CTXφ prophage with the ctxB7 genotype compared to historical Malawian Vc isolates. These data suggest that the devastating cyclones coupled with the recent importation of 7PET serogroup O1 strains, may explain the magnitude of the 2022-2023 cholera outbreak in Malawi.
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Affiliation(s)
- Chrispin Chaguza
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA.
- Yale Institute for Global Health, Yale University, New Haven, CT, USA.
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
- NIHR Mucosal Pathogens Research Unit, Research Department of Infection, Division of Infection and Immunity, University College London, London, UK.
- Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, UK.
| | - Innocent Chibwe
- Public Health Institute of Malawi, Ministry of Health, Lilongwe, Malawi
| | - David Chaima
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Patrick Musicha
- Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, UK
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - Latif Ndeketa
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | | | | | - Upendo L Mseka
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | | | - Bernard Mvula
- Public Health Institute of Malawi, Ministry of Health, Lilongwe, Malawi
| | - Wakisa Kipandula
- Department of Medical Laboratory Sciences, Faculty of Biomedical Sciences and Health profession, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Patrick Bonongwe
- Ministry of Health, Balaka District Hospital, Balaka, Machinga, Malawi
| | - Richard J Munthali
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Selemani Ngwira
- Public Health Institute of Malawi, Ministry of Health, Lilongwe, Malawi
| | - Chikondi A Mwendera
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Akuzike Kalizang'oma
- NIHR Mucosal Pathogens Research Unit, Research Department of Infection, Division of Infection and Immunity, University College London, London, UK
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - Kondwani C Jambo
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Arox W Kamng'ona
- Department of Biomedical Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - A Duncan Steele
- Diarrhoeal Pathogens Research Unit, Sefako Makgatho Health Sciences University, Medunsa, 0204, Pretoria, South Africa
| | | | - Daniel Hungerford
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - Matthew Kagoli
- Public Health Institute of Malawi, Ministry of Health, Lilongwe, Malawi
| | - Martin M Nyaga
- Next Generation Sequencing Unit and Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa
| | - Queen Dube
- Malawi Ministry of Health, Lilongwe, Malawi
| | - Neil French
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - Chisomo L Msefula
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Nigel A Cunliffe
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
- NIHR Global Health Research Group on Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - Khuzwayo C Jere
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi.
- Department of Medical Laboratory Sciences, Faculty of Biomedical Sciences and Health profession, Kamuzu University of Health Sciences, Blantyre, Malawi.
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.
- NIHR Global Health Research Group on Gastrointestinal Infections, University of Liverpool, Liverpool, UK.
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Figuereo S, Yoon I, Kaddu SS, Lubogo M, Baruch J, Hossain AA, Mohamed SI, Abubakar AHA, Mohamud KM, Malik SMMR. Cost of Cholera for Households and Health Facilities, Somalia. J Epidemiol Glob Health 2024:10.1007/s44197-024-00278-6. [PMID: 39023718 DOI: 10.1007/s44197-024-00278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024] Open
Abstract
INTRODUCTION Cholera remains a substantial public health challenge in Somalia. Ongoing droughts in the country have caused significant outbreaks which have negatively affected the lives of many individuals and overwhelmed health facilities. We aimed to estimate the costs associated with cholera cases for households and health facilities in Somalia. METHODS This cost-of-illness study was conducted in five cholera treatment centres in Somalia and 400 patients treated in these facilities. Data collection took place during October and November 2023. Given that a significant portion of the patients were children, we interviewed their caregivers to gather cost data. We interviewed staff at the centres and the patients. The data obtained from the household questionnaire covered direct (medical and non-medical) and indirect (lost wages) costs, while direct costs were estimated for the health facility (personnel salaries, drugs and consumables used to treat a patient, and utility expenses). All costs were calculated in US dollars (USD), using 2023 as the base year for the estimation. RESULTS The average total cost of a cholera episode for a household was US$ 33.94 (2023 USD), with 50.4% (US$ 17.12) being direct costs and 49.6% (US$ 16.82) indirect costs. The average total cost for a health facility to treat an episode of cholera was US$ 82.65. The overall average cost to households and health facilities was US$ 116.59. The average length of stay for a patient was 3.08 days. In the households, patients aged 41 years and older incurred the highest mean total cost (US$ 73.90) while patients younger than 5 years had the lowest cost (US$ 21.02). Additionally, 61.8% of households had to use family savings to cover the cost of the cholera episode, while 14.5% had to borrow money. Most patients (71.8%) were younger than 16 years- 45.3% were 5 years or younger- and 94.0% had never received a cholera vaccine. CONCLUSION Our study suggests that preventing one cholera episode in Somalia could avert substantial losses for both the households and cholera treatment centres. The findings shed light on the expenses associated with cholera that extend beyond healthcare, including substantial direct and indirect costs borne by households. Preventing cholera cases could lead to a decrease in this economic burden, consequently our study supports the need for preventive measures.
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Affiliation(s)
- Salvador Figuereo
- World Health Organization, Somalia Country Office, Mogadishu, Somalia.
| | - Ian Yoon
- World Health Organization, Headquarters, Geneva, Switzerland
| | | | - Mutaawe Lubogo
- World Health Organization, Somalia Country Office, Mogadishu, Somalia
| | - Joaquin Baruch
- World Health Organization, Somalia Country Office, Mogadishu, Somalia
| | - Asm Amjad Hossain
- World Health Organization, Somalia Country Office, Mogadishu, Somalia
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Worku Demlie Y, Gedefaw A, Jeon Y, Hailu D, Getahun T, Mogeni OD, Mukasa D, Jang GH, Pak GD, Kim DR, Getachew EM, Yeshitela B, Ayele Abebe S, Edosa M, Wossen M, Teferi M, Park SE. Retrospective Analysis of Cholera/Acute Watery Diarrhea Outbreaks in Ethiopia From 2001 To 2023: Incidence, Case Fatality Rate, and Seasonal and Multiyear Epidemic Patterns. Clin Infect Dis 2024; 79:S8-S19. [PMID: 38996039 PMCID: PMC11244192 DOI: 10.1093/cid/ciae236] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND The Ethiopian government has developed the multisectoral cholera elimination plan (NCP) with an aim of reducing cholera incidence and case fatality rate (CFR). To better understand and monitor the progress of this plan, a comprehensive review of national cholera epidemiology is needed. METHODS Reported data on cholera/acute watery diarrhea (AWD) cases in the past 20 years were extracted from the Ethiopian Public Health Institute and World Health Organization databases. Descriptive statistics, Pearson χ2, and logistic regression analyses were conducted. RESULTS From January 2001 to November 2023, a total of 215 205 cholera/AWD cases, 2355 deaths with a cumulative CFR of 1.10% (95% confidence interval [CI], 1.092-1.095), and a mean annual incidence rate of 8.9/100 000 (95% CI, 6.5-11.3) were reported. Two major upsurges of cholera epidemics were found in the last two decades with mean attack rate (AR) of 20.57/100 000 in 2006-2010 and 14.83/100 000 in 2016-2020. Another resurgence of outbreaks occured in 2021-2023 (mean AR, 8.63/100 000). In 2015-2023, 54.0% (53 990/99 945) of cases were aged 15-44 years. National cholera CFR (3.13% [95% CI: 2.1-4.5]) was the highest in 2022. The 2015-2023 cumulative cholera CFR was different across regions: Benishangul Gumuz (6.07%), Gambela (1.89%), Sidama (1.42%), Southern Nation, Nationalities, and Peoples' (1.34%), Oromia (1.10%), and Amhara (1.09%). Cholera/AWD patients in older adults (≥45 years), severe dehydration, peak rainy season (June-August), and outpatients were associated with higher risk of death. CONCLUSIONS Cholera has been a public health problem in Ethiopia with case fatalities still above the global target. Case management needs to be improved particularly in outpatients and older populations. Outbreak preparedness should be rolled out well in advance of the typical rainy seasons. Significant investments are essential to advance the cholera surveillance system at healthcare setting and community level. Underlying factors of cholera deaths per areas should be further investigated to guide appropriate interventions to meet the NCP target by 2028.
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Affiliation(s)
- Yeshambel Worku Demlie
- Diseases Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Abel Gedefaw
- Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Yeonji Jeon
- Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - Dejene Hailu
- Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea
- School of Public Health, Hawassa University, Hawassa, Ethiopia
| | - Tomas Getahun
- Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Ondari D Mogeni
- Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea
| | - David Mukasa
- Biostatistics and Data Management Department (BDM), International Vaccine Institute, Seoul, Republic of Korea
| | - Geun Hyeog Jang
- Biostatistics and Data Management Department (BDM), International Vaccine Institute, Seoul, Republic of Korea
| | - Gi Deok Pak
- Biostatistics and Data Management Department (BDM), International Vaccine Institute, Seoul, Republic of Korea
| | - Deok Ryun Kim
- Biostatistics and Data Management Department (BDM), International Vaccine Institute, Seoul, Republic of Korea
| | | | - Biruk Yeshitela
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Samuyel Ayele Abebe
- Data Science Division, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Moti Edosa
- Diseases Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Mesfin Wossen
- Diseases Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Mekonnen Teferi
- Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Se Eun Park
- Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea
- Department of Global Health and Disease Control, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea
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Wang Y, Luo J, Zhao Y, Zhang J, Guan X, Sun L. Haemolysins are essential to the pathogenicity of deep-sea Vibrio fluvialis. iScience 2024; 27:109558. [PMID: 38650982 PMCID: PMC11033176 DOI: 10.1016/j.isci.2024.109558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/19/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
Vibrio fluvialis is an emerging foodborne pathogen that produces VFH (Vibrio fluvialis hemolysin) and δVFH (delta-Vibrio fluvialis hemolysin). The function of δVFH is unclear. Currently, no pathogenic V. fluvialis from deep sea has been reported. In this work, a deep-sea V. fluvialis isolate (V13) was examined for pathogenicity. V13 was most closely related to V. fluvialis ATCC 33809, a human isolate, but possessed 262 unique genes. V13 caused lethal infection in fish and induced pyroptosis involving activation of the NLRP3 inflammasome, caspase 1 (Casp1), and gasdermin D (GSDMD). V13 defective in VFH or VFH plus δVFH exhibited significantly weakened cytotoxicity. Recombinant δVFH induced NLRP3-Casp1-GSDMD-mediated pyroptosis in a manner that depended on K+ efflux and intracellular Ca2+ accumulation. δVFH bound several plasma membrane lipids, and these bindings were crucial for δVFH cytotoxicity. Together these results provided new insights into the function of δVFH and the virulence mechanism of V. fluvialis.
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Affiliation(s)
- Yujian Wang
- CAS and Shandong Province Key Laboratory of Experimental Marine Biology, Institute of Oceanology, Center for Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
- Laboratory for Marine Biology and Biotechnology, Qingdao Marine Science and Technology Center, Qingdao 266237, China
| | - Jingchang Luo
- CAS and Shandong Province Key Laboratory of Experimental Marine Biology, Institute of Oceanology, Center for Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
- Laboratory for Marine Biology and Biotechnology, Qingdao Marine Science and Technology Center, Qingdao 266237, China
- College of Marine Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yan Zhao
- Tsinghua-Peking Joint Center for Life Sciences, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Jian Zhang
- School of Ocean, Yantai University, Yantai 264005, China
| | - Xiaolu Guan
- CAS and Shandong Province Key Laboratory of Experimental Marine Biology, Institute of Oceanology, Center for Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
- Laboratory for Marine Biology and Biotechnology, Qingdao Marine Science and Technology Center, Qingdao 266237, China
| | - Li Sun
- CAS and Shandong Province Key Laboratory of Experimental Marine Biology, Institute of Oceanology, Center for Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
- Laboratory for Marine Biology and Biotechnology, Qingdao Marine Science and Technology Center, Qingdao 266237, China
- College of Marine Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
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7
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Maluda MCM, Johnson E, Robinson F, Jikal M, Fong SY, Saffree MJ, Fornace KM, Ahmed K. The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002861. [PMID: 38289918 PMCID: PMC10826939 DOI: 10.1371/journal.pgph.0002861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/07/2024] [Indexed: 02/01/2024]
Abstract
Vibrio cholerae remains a notable public health challenge across Malaysia. Although the Malaysian state of Sabah is considered a cholera-affected area, gaps remain in understanding the epidemiological trends and spatial distribution of outbreaks. Therefore, to determine longitudinal and spatial trends in cholera cases data were obtained from the Sabah State Health Department for all notified cases of cholera between 2005-2020. A cholera outbreak is defined as one or more confirmed cases in a single locality with the evidence of local transmission. All records were geolocated to village level. Satellite-derived data and generalised linearized models were used to assess potential risk factors, including population density, elevation, and distance to the sea. Spatiotemporal clustering of reported cholera cases and zones of increased cholera risk were evaluated using the tau statistic (τ) at 550m, 5km and 10km distances. Over a 15-year period between 2005-2020, 2865 cholera cases were recorded in Sabah, with a mean incidence rate of 5.6 cases per 100,000 (95% CI: 3.4-7.9). From 2015-2020, 705 symptomatic cases and 727 asymptomatic cases were reported. Symptomatic cases primarily occurred in local Malaysian populations (62.6%, 441/705) and in children and adolescents under 15-years old (49.4%, 348/705). On average, cases were reported in areas with low population density (19.45 persons/km2), low elevations (19.45m) and near coastal areas. Spatiotemporal clustering of cholera cases was identified up to 3.5km, with increased village-level cholera risk within 500m and 5 days of initial case presentation to a health facility (Risk Ratio = 9.7, 95% CI: 7.5-12.4). Cholera incidence has high spatial and temporal heterogeneity within Sabah, with some districts experiencing repeated outbreaks. Cholera cases clustered across space and time, with village-level risk of cholera highest within 5 days and within close proximity to primary case villages, suggesting local transmission.
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Affiliation(s)
- Marilyn Charlene Montini Maluda
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Emilia Johnson
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Fredie Robinson
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Muhammad Jikal
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Siat Yee Fong
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohammad Jeffree Saffree
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kimberly M. Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
- Faculty of Infectious and Tropical Diseases and Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan
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8
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Jalalizadeh F, Njamkepo E, Weill FX, Goodarzi F, Rahnamaye-Farzami M, Sabourian R, Bakhshi B. Genetic approach toward linkage of Iran 2012-2016 cholera outbreaks with 7th pandemic Vibrio cholerae. BMC Microbiol 2024; 24:33. [PMID: 38254012 PMCID: PMC10801964 DOI: 10.1186/s12866-024-03185-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Vibrio cholerae, as a natural inhabitant of the marine environment is among the world-leading causes of diarrheal diseases. The present study aimed to investigate the genetic relatedness of Iran 2012-2016 V. cholerae outbreaks with 7th pandemic cholera and to further characterize the non-ST69/non-ST75 sequence types strains by whole-genome sequencing (WGS).Twenty V. cholerae isolates related to 2012, 2013, 2015 and 2016 cholera outbreaks were studied by two genotyping methods - Pulsed-field Gel Electrophoresis (PFGE) and Multi-locus Sequence Typing (MLST)-and by antimicrobial susceptibility testing. Seven sequence types (STs) and sixteen pulsotypes were detected. Sequence type 69 was the most abundant ST confirming that most (65%, 13/20) of the studied isolates collected in Iran between 2012 and 2016 belonged to the 7th pandemic clone. All these ST69 isolates (except two) exhibited similar pulsotypes. ST75 was the second most abundant ST. It was identified in 2015 and 2016. ST438, ST178, ST579 and STs of 983 and 984 (as newfound STs) each were only detected in one isolate. All strains collected in 2016 appeared as distinct STs and pulsotypes indicative of probable different originations. All ST69 strains were resistant to nalidixic acid. Moreover, resistance to nalidixic acid, trimethoprim-sulfamethoxazole and tetracycline was only observed in strains of ST69. These properties propose the ST69 as a unique genotype derived from a separate lineage with distinct resistance properties. The circulation of V. cholerae ST69 and its traits in recent years in Iran proposes the 7th pandemic strains as the ongoing causes of cholera outbreaks in this country, although the role of ST75 as the probable upcoming dominant ST should not be ignored.Genomic analysis of non-ST69/non-ST75 strains in this study showed ST579 is the most similar ST type to 7th pandemic sequence types, due to the presence of wild type-El Tor sequences of tcpA and VC-1319, VC-1320, VC-1577, VC-1578 genes (responsible for polymyxin resistance in El Tor biotype), the traits of rstC of RS1 phage in one strain of this ST type and the presence of VPI-1 and VSP-I islands in ST579 and ST178 strains. In silico analysis showed no significant presence of resistance genes/cassettes/plasmids within non-ST69/non-ST75 strains genomes. Overall, these data indicate the higher susceptibility of V. cholerae non-ST69/non-ST75 strains in comparison with more ubiquitous and more circulating ST69 and ST75 strains.In conclusion, the occurrence of small outbreaks and sporadic cholera cases due to V. cholerae ST69 in recent years in Iran shows the 7th pandemic strains as the persistent causes of cholera outbreaks in this country, although the role of ST75 as the second most contributed ST should not be ignored. The occurrence of non-ST69/non-ST75 sequence types with some virulence factors characteristics in border provinces in recent years is noteworthy, and further studies together with surveillance efforts are expected to determine their likely route of transport.
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Affiliation(s)
- Fatemeh Jalalizadeh
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | | | - Forough Goodarzi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | | | - Bita Bakhshi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Netter Z, Dunham DT, Seed KD. Adaptation to bile and anaerobicity limits Vibrio cholerae phage adsorption. mBio 2023; 14:e0198523. [PMID: 37882540 PMCID: PMC10746206 DOI: 10.1128/mbio.01985-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023] Open
Abstract
IMPORTANCE Vibrio cholerae is the bacterial pathogen responsible for cholera, a diarrheal disease that impacts people in areas without access to potable water. In regions that lack such infrastructure, cholera represents a large proportion of disease outbreaks. Bacteriophages (phages, viruses that infect bacteria) have recently been examined as potential therapeutic and prophylactic agents to treat and prevent bacterial disease outbreaks like cholera due to their specificity and stability. This work examines the interaction between V. cholerae and vibriophages in consideration for a cholera prophylaxis regimen (M. Yen, L. S. Cairns, and A. Camilli, Nat Commun 8:14187, 2017, https://doi.org/10.1038/ncomms14187) in the context of stimuli found in the intestinal environment. We discover that common signals in the intestinal environment induce cell surface modifications in V. cholerae that also restrict some phages from binding and initiating infection. These findings could impact considerations for the design of phage-based treatments, as phage infection appears to be limited by bacterial adaptations to the intestinal environment.
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Affiliation(s)
- Zoe Netter
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, California, USA
| | - Drew T. Dunham
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, California, USA
| | - Kimberley D. Seed
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, California, USA
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Li Y, Yan J, Li J, Xue X, Wang Y, Cao B. A novel quorum sensing regulator LuxT contributes to the virulence of Vibrio cholerae. Virulence 2023; 14:2274640. [PMID: 37908129 PMCID: PMC10621291 DOI: 10.1080/21505594.2023.2274640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/18/2023] [Indexed: 11/02/2023] Open
Abstract
Vibrio cholerae is a waterborne bacterium that primarily infects the human intestine and causes cholera fatality. Quorum sensing (QS) negatively regulates the expression of V. cholerae virulence gene. However, the primary associated mechanisms remain undetermined. This investigation identified a new QS regulator from the TetR family, LuxT, which increases V. cholerae virulence by directly inhibiting hapR expression. HapR is a master QS regulator that suppresses virulence cascade expression. The expression of luxT increased 4.8-fold in the small intestine of infant mice than in Luria-Bertani broth. ΔluxT mutant strain revealed a substantial defect in the colonizing ability of the small intestines. At low cell densities, the expression level of hapR was upregulated by luxT deletion, suggesting that LuxT can suppress hapR transcription. The electrophoretic mobility shift analysis revealed that LuxT directly binds to the hapR promoter region. Furthermore, luxT expression was upregulated by the two-component system ArcB/ArcA, which responses to changes in oxygen levels in response to the host's small intestine's anaerobic signals. In conclusion, this research reveals a novel cell density-mediated virulence regulation pathway and contributes to understanding the complex association between V. cholerae virulence and QS signals. This evidence furnishes new insights for future studies on cholerae's pathogenic mechanisms.
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Affiliation(s)
- Yuehua Li
- TEDA Institute of Biological Sciences and Biotechnology, Nankai University, Tianjin, China
- Key Laboratory of Molecular Microbiology and Technology of the Ministry of Education, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Microbial Functional Genomics, TEDA College, Nankai University, Tianjin, China
| | - Junxiang Yan
- TEDA Institute of Biological Sciences and Biotechnology, Nankai University, Tianjin, China
- Key Laboratory of Molecular Microbiology and Technology of the Ministry of Education, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Microbial Functional Genomics, TEDA College, Nankai University, Tianjin, China
| | - Jinghao Li
- TEDA Institute of Biological Sciences and Biotechnology, Nankai University, Tianjin, China
- Key Laboratory of Molecular Microbiology and Technology of the Ministry of Education, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Microbial Functional Genomics, TEDA College, Nankai University, Tianjin, China
| | - Xinke Xue
- TEDA Institute of Biological Sciences and Biotechnology, Nankai University, Tianjin, China
- Key Laboratory of Molecular Microbiology and Technology of the Ministry of Education, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Microbial Functional Genomics, TEDA College, Nankai University, Tianjin, China
| | - Ying Wang
- TEDA Institute of Biological Sciences and Biotechnology, Nankai University, Tianjin, China
- Key Laboratory of Molecular Microbiology and Technology of the Ministry of Education, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Microbial Functional Genomics, TEDA College, Nankai University, Tianjin, China
| | - Boyang Cao
- TEDA Institute of Biological Sciences and Biotechnology, Nankai University, Tianjin, China
- Key Laboratory of Molecular Microbiology and Technology of the Ministry of Education, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Microbial Functional Genomics, TEDA College, Nankai University, Tianjin, China
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Kelly M, Jeon S, Yun J, Lee B, Park M, Whang Y, Lee C, Charles RC, Bhuiyan TR, Qadri F, Kamruzzaman M, Cho S, Vann WF, Xu P, Kováč P, Ganapathy R, Lynch J, Ryan ET. Vaccination of Rabbits with a Cholera Conjugate Vaccine Comprising O-Specific Polysaccharide and a Recombinant Fragment of Tetanus Toxin Heavy Chain Induces Protective Immune Responses against Vibrio cholerae O1. Am J Trop Med Hyg 2023; 109:1122-1128. [PMID: 37783453 PMCID: PMC10622467 DOI: 10.4269/ajtmh.23-0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/16/2023] [Indexed: 10/04/2023] Open
Abstract
There is a need for next-generation cholera vaccines that provide high-level and durable protection in young children in cholera-endemic areas. A cholera conjugate vaccine (CCV) is in development to address this need. This vaccine contains the O-specific polysaccharide (OSP) of Vibrio cholerae O1 conjugated via squaric acid chemistry to a recombinant fragment of the tetanus toxin heavy chain (OSP:rTTHc). This vaccine has been shown previously to be immunogenic and protective in mice and found to be safe in a recent preclinical toxicological analysis in rabbits. We took advantage of excess serum samples collected as part of the toxicological study and assessed the immunogenicity of CCV OSP:rTTHc in rabbits. We found that vaccination with CCV induced OSP-, lipopolysaccharide (LPS)-, and rTTHc-specific immune responses in rabbits, that immune responses were functional as assessed by vibriocidal activity, and that immune responses were protective against death in an established virulent challenge assay. CCV OSP:rTTHc immunogenicity in two animal model systems (mice and rabbits) is encouraging and supports further development of this vaccine for evaluation in humans.
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Affiliation(s)
- Meagan Kelly
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
| | - Suhi Jeon
- Eubiologics Ltd, Gangnam-gu, Seoul, South Korea
| | - Jeesun Yun
- Eubiologics Ltd, Gangnam-gu, Seoul, South Korea
| | - Byungman Lee
- Department of Biological Engineering, Inha University, Incheon, South Korea
| | | | | | - Chankyu Lee
- Eubiologics Ltd, Gangnam-gu, Seoul, South Korea
| | - Richelle C. Charles
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Taufiqur R. Bhuiyan
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Firdausi Qadri
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Mohammad Kamruzzaman
- icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | - Somyoung Cho
- International Vaccine Institute, Seoul, South Korea
| | - Willie F. Vann
- Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Peng Xu
- National Institute of Diabetes and Digestive and Kidney Diseases, Laboratory of Bioorganic Chemistry, NIH, Bethesda, Maryland
| | - Pavol Kováč
- National Institute of Diabetes and Digestive and Kidney Diseases, Laboratory of Bioorganic Chemistry, NIH, Bethesda, Maryland
| | | | - Julia Lynch
- International Vaccine Institute, Seoul, South Korea
| | - Edward T. Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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12
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Li Y, Yang KD, Kong DC, Ye JF. Advances in phage display based nano immunosensors for cholera toxin. Front Immunol 2023; 14:1224397. [PMID: 37781379 PMCID: PMC10534012 DOI: 10.3389/fimmu.2023.1224397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Cholera, a persistent global public health concern, continues to cause outbreaks in approximately 30 countries and territories this year. The imperative to safeguard water sources and food from Vibrio cholerae, the causative pathogen, remains urgent. The bacterium is mainly disseminated via ingestion of contaminated water or food. Despite the plate method's gold standard status for detection, its time-consuming nature, taking several days to provide results, remains a challenge. The emergence of novel virulence serotypes raises public health concerns, potentially compromising existing detection methods. Hence, exploiting Vibrio cholerae toxin testing holds promise due to its inherent stability. Immunobiosensors, leveraging antibody specificity and sensitivity, present formidable tools for detecting diverse small molecules, encompassing drugs, hormones, toxins, and environmental pollutants. This review explores cholera toxin detection, highlighting phage display-based nano immunosensors' potential. Engineered bacteriophages exhibit exceptional cholera toxin affinity, through specific antibody fragments or mimotopes, enabling precise quantification. This innovative approach promises to reshape cholera toxin detection, offering an alternative to animal-derived methods. Harnessing engineered bacteriophages aligns with ethical detection and emphasizes sensitivity and accuracy, a pivotal stride in the evolution of detection strategies. This review primarily introduces recent advancements in phage display-based nano immunosensors for cholera toxin, encompassing technical aspects, current challenges, and future prospects.
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Affiliation(s)
- Yang Li
- General Surgery Center, First Hospital of Jilin University, Changchun, Jilin, China
- School of Nursing, Jilin University, Changchun, China
| | - Kai-di Yang
- School of Nursing, Jilin University, Changchun, China
| | - De-cai Kong
- General Surgery Center, First Hospital of Jilin University, Changchun, Jilin, China
| | - Jun-feng Ye
- General Surgery Center, First Hospital of Jilin University, Changchun, Jilin, China
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13
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Qayum MO, Billah MM, Sarker MFR, Alamgir ASM, Nurunnahar M, Khan MH, Salim Uzzaman M, Henderson A, Shirin T, Flora MS. Oral cholera vaccine coverage evaluation survey: Forcibly Displaced Myanmar Nationals and host community in Cox's Bazar, Bangladesh. Front Public Health 2023; 11:1147563. [PMID: 37475769 PMCID: PMC10354286 DOI: 10.3389/fpubh.2023.1147563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/31/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Cholera remains a significant public health concern in many parts of the world, particularly in areas with poor sanitation and hygiene. Bangladesh and other impoverished nations have been severely affected by cholera outbreaks, especially in areas with a high population density. In order to mitigate the spread of cholera, oral cholera vaccines (OCVs) are recommended as a prophylactic measure. In May 2018, 775,666 of the Forcibly Displaced Myanmar Nationals (FDMN) in the registered and makeshift camps and 103,605 of the residents in the host community received two doses of OCV ShancholTM in Cox's Bazar, Bangladesh, because the conditions in the area favored the transmission of cholera and other waterborne diseases. This study aimed to assess the coverage of OCV among the FDMN and the host community in Cox's Bazar. Methods In August 2018, we enrolled 4,240 respondents for this study following the "World Health Organization (WHO) Vaccination Coverage Cluster Surveys: Reference Manual (2018)." The coverage survey was conducted with three strata of the population: the host community from the Teknaf Upazila, the registered camp, and the makeshift camp from the Ukhia Upazila. We collected information regarding OCV coverage, demographic characteristics, and knowledge and behaviors of people toward the vaccine. The data were analyzed using descriptive statistics. Results According to our study, the overall OCV coverage was 85%, with 68% in the host community, 91% in the registered camp, and 98% in the makeshift camp. The lower coverage in the host community was due to residents unaware of the vaccination campaign, the unavailability of vaccines, and unaware where to go for vaccination. Discussion Our findings demonstrate that the OCV campaign in the FDMN camps was successful, reaching over 90% coverage, while coverage in the host community was much lower. In order to make sure that OCV vaccination efforts are reaching the target population and having the desired impact, our study emphasizes the need to inform the target population of when and where to get vaccinated.
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Affiliation(s)
- Md. Omar Qayum
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Mallick Masum Billah
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | | | - A. S. M. Alamgir
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Mehejabin Nurunnahar
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Manjur Hossain Khan
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - M. Salim Uzzaman
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Alden Henderson
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Tahmina Shirin
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
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14
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Maity B, Saha B, Ghosh I, Chattopadhyay J. Model-Based Estimation of Expected Time to Cholera Extinction in Lusaka, Zambia. Bull Math Biol 2023; 85:55. [PMID: 37208444 DOI: 10.1007/s11538-023-01149-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 03/23/2023] [Indexed: 05/21/2023]
Abstract
The developing world has been facing a significant health issue due to cholera as an endemic communicable disease. Lusaka was Zambia's worst affected province, with 5414 reported cases of cholera during the outbreak from late October 2017 to May 12, 2018. To explore the epidemiological characteristics associated with the outbreak, we fitted weekly reported cholera cases with a compartmental disease model that incorporates two transmission routes, namely environment-to-human and human-to-human. Estimates of the basic reproduction number show that both transmission modes contributed almost equally during the first wave. In contrast, the environment-to-human transmission appears to be mostly dominating factor for the second wave. Our study finds that a massive abundance of environmental vibrio's with a huge reduction in water sanitation efficacy triggered the secondary wave. To estimate the expected time to extinction (ETE) of cholera, we formulate the stochastic version of our model and find that cholera can last up to 6.5-7 years in Lusaka if any further outbreak occurs at a later time. Results indicate that a considerable amount of attention is to be paid to sanitation and vaccination programs in order to reduce the severity of the disease and to eradicate cholera from the community in Lusaka.
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Affiliation(s)
- Biplab Maity
- Agricultural and Ecological Research Unit, Indian Statistical Institute, 203, B. T. Road, Kolkata, West Bengal, 700108, India.
| | - Bapi Saha
- Department of Mathematics, Government College of Engineering and Textile Technology, 4 Barrack square, Berhampore, West Bengal, 742101, India
| | - Indrajit Ghosh
- Department of Epidemiology and Biostatistics, University of Georgia, 105 Spear Rd, Athens, Georgia, 30606, USA
| | - Joydev Chattopadhyay
- Agricultural and Ecological Research Unit, Indian Statistical Institute, 203, B. T. Road, Kolkata, West Bengal, 700108, India
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15
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Abstract
In order for successful fecal-oral transmission, enteric bacterial pathogens have to successfully compete with the intestinal microbiota and reach high concentrations during infection. Vibrio cholerae requires cholera toxin (CT) to cause diarrheal disease, which is thought to promote the fecal-oral transmission of the pathogen. Besides inducing diarrheal disease, the catalytic activity of CT also alters host intestinal metabolism, which promotes the growth of V. cholerae during infection through the acquisition of host-derived nutrients. Furthermore, recent studies have found that CT-induced disease activates a niche-specific suite of V. cholerae genes during infection, some of which may be important for fecal-oral transmission of the pathogen. Our group is currently exploring the concept that CT-induced disease promotes the fecal-oral transmission of V. cholerae by modulating both host and pathogen metabolism. Furthermore, the role of the intestinal microbiota in pathogen growth and transmission during toxin-induced disease merits further investigation. These studies open the door to investigating whether other bacterial toxins also enhance pathogen growth and transmission during infection, which may shed light on the design of novel therapeutics for intervention or prevention of diarrheal diseases.
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Affiliation(s)
- Claire M. L. Chapman
- Division of Host-Microbe Systems and Therapeutics, Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
- Department of Molecular Biology, School of Biological Sciences, University of California, San Diego, La Jolla, California, USA
| | - Andrew Kapinos
- Division of Host-Microbe Systems and Therapeutics, Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
- Department of Molecular Biology, School of Biological Sciences, University of California, San Diego, La Jolla, California, USA
| | - Fabian Rivera-Chávez
- Division of Host-Microbe Systems and Therapeutics, Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
- Department of Molecular Biology, School of Biological Sciences, University of California, San Diego, La Jolla, California, USA
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Charnley GEC, Yennan S, Ochu C, Kelman I, Gaythorpe KAM, Murray KA. Cholera past and future in Nigeria: Are the Global Task Force on Cholera Control's 2030 targets achievable? PLoS Negl Trop Dis 2023; 17:e0011312. [PMID: 37126498 PMCID: PMC10174485 DOI: 10.1371/journal.pntd.0011312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/11/2023] [Accepted: 04/15/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Understanding and continually assessing the achievability of global health targets is key to reducing disease burden and mortality. The Global Task Force on Cholera Control (GTFCC) Roadmap aims to reduce cholera deaths by 90% and eliminate the disease in twenty countries by 2030. The Roadmap has three axes focusing on reporting, response and coordination. Here, we assess the achievability of the GTFCC targets in Nigeria and identify where the three axes could be strengthened to reach and exceed these goals. METHODOLOGY/PRINCIPAL FINDINGS Using cholera surveillance data from Nigeria, cholera incidence was calculated and used to model time-varying reproduction number (R). A best fit random forest model was identified using R as the outcome variable and several environmental and social covariates were considered in the model, using random forest variable importance and correlation clustering. Future scenarios were created (based on varying degrees of socioeconomic development and emission reductions) and used to project future cholera transmission, nationally and sub-nationally to 2070. The projections suggest that significant reductions in cholera cases could be achieved by 2030, particularly in the more developed southern states, but increases in cases remain a possibility. Meeting the 2030 target, nationally, currently looks unlikely and we propose a new 2050 target focusing on reducing regional inequities, while still advocating for cholera elimination being achieved as soon as possible. CONCLUSION/SIGNIFICANCE The 2030 targets could potentially be reached by 2030 in some parts of Nigeria, but more effort is needed to reach these targets at a national level, particularly through access and incentives to cholera testing, sanitation expansion, poverty alleviation and urban planning. The results highlight the importance of and how modelling studies can be used to inform cholera policy and the potential for this to be applied in other contexts.
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Affiliation(s)
- Gina E C Charnley
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Sebastian Yennan
- Surveillance and Epidemiology Department/IM Cholera, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Chinwe Ochu
- Surveillance and Epidemiology Department/IM Cholera, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Ilan Kelman
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom
- Institute for Global Health, University College London, London, United Kingdom
- University of Agder, Kristiansand, Norway
| | - Katy A M Gaythorpe
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Kris A Murray
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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17
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Akel M, Sakr F, Haddad C, Hajj A, Sacre H, Zeenny RM, Safwan J, Salameh P. Knowledge, Attitude, and Practices of the General Population toward the Old-New Outbreak of Cholera in a Developing Country. Trop Med Infect Dis 2023; 8:tropicalmed8040236. [PMID: 37104361 PMCID: PMC10144007 DOI: 10.3390/tropicalmed8040236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
Background: In October 2022, the first case of cholera since 1993 was recorded in Lebanon. This study aimed to develop and validate a tool to explore the knowledge, attitudes, and practices (KAP) toward cholera infection and its prevention among the general population in Lebanon and identify the associated factors related to the KAP assessment to guide prevention and awareness strategies. The nation's already precarious healthcare system might become overwhelmed by the response to the cholera outbreak. Therefore, evaluating the level of cholera-related KAP among the Lebanese population is crucial since it directly affects the disease's treatment, control, and prevention. Methods: This online cross-sectional study was carried out between October and November 2022 during the cholera outbreak in Lebanon. Snowball sampling was used to recruit 448 adults living in Lebanon. Results: The suggested KAP scales had adequate structural and convergent validity and were internally consistent. The disease knowledge was inversely associated with the reluctance to receive educational information (β = -1.58) and cigarette smoking (β = -1.31) but positively associated with the female gender (β = 1.74) and awareness of vaccine availability and efficacy (β = 1.34). For attitude, healthcare professionals were less frightened than others (β = 2.69). Better practices were related to better knowledge (β = 0.43), while inadequate practices were associated with getting information from social media (β = -2.47). Conclusions: This study could identify notable gaps in the knowledge, attitudes, and practices, which varied according to participant characteristics. Cholera incidence can be reduced by improved community education and training, increased access to safe water, sanitation, and hygiene amenities, and changes in behavior. These findings warrant additional actions by public health stakeholders and governmental authorities to promote better practices and curb disease transmission.
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Affiliation(s)
- Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut P.O. Box 146404, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 12109, Lebanon
- School of Education, Lebanese International University, Beirut P.O. Box 146404, Lebanon
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut P.O. Box 146404, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 12109, Lebanon
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 12109, Lebanon
- School of Medicine, Lebanese American University, Byblos P.O. Box 13-5053, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jall Eddib P.O. Box 60096, Lebanon
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 12109, Lebanon
- Faculté de Pharmacie, Université Laval, Québec G1V 0A6, Canada
- Oncology Division, CHU de Québec Université Laval Research Center, Québec G1S 4L8, Canada
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicament, Faculté de Pharmacie, Université Saint-Joseph de Beyrouth, Beirut P.O. Box 1107-2180, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 12109, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut P.O. Box 11-2807, Lebanon
| | - Rony M Zeenny
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 12109, Lebanon
- Department of Pharmacy, American University of Beirut Medical Center, Beirut P.O. Box 11-0236, Lebanon
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut P.O. Box 146404, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 12109, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut P.O. Box 12109, Lebanon
- School of Medicine, Lebanese American University, Byblos P.O. Box 13-5053, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadath P.O. Box 6573-14, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia 2417, Cyprus
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Das R, Nasrin S, Palit P, Sobi RA, Sultana AA, Khan SH, Haque MA, Nuzhat S, Ahmed T, Faruque ASG, Chisti MJ. Vibrio cholerae in rural and urban Bangladesh, findings from hospital-based surveillance, 2000-2021. Sci Rep 2023; 13:6411. [PMID: 37076586 PMCID: PMC10115832 DOI: 10.1038/s41598-023-33576-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 04/14/2023] [Indexed: 04/21/2023] Open
Abstract
With more than 100,000 cases estimated each year, Bangladesh is one of the countries with the highest number of people at risk for cholera. Moreover, Bangladesh is formulating a countrywide cholera-control plan to satisfy the GTFCC (The Global Task Force on Cholera Control) Roadmap's goals. With a particular focus on cholera trends, variance in baseline and clinical characteristics of cholera cases, and trends in antibiotic susceptibility among clinical isolates of Vibrio cholerae, we used data from facility-based surveillance systems from icddr,b's Dhaka, and Matlab Hospitals from years 2000 to 2021. Female patients comprised 3,553 (43%) in urban and 1,099 (51.6%) in rural sites. Of the cases and most patients 5,236 (63.7%) in urban and 1,208 (56.7%) in the rural site were aged 15 years and more. More than 50% of the families belonged to the poor and lower-middle-class; in 2009 (24.4%) were in urban and in 1,791 (84.2%) were in rural sites. In the urban site, 2,446 (30%) of households used untreated drinking water, and 702 (9%) of families disposed of waste in their courtyard. In the multiple logistic regression analysis, the risk of cholera has significantly increased due to waste disposal in the courtyard and the boiling of water has a protective effect against cholera. Rotavirus (9.7%) was the most prevalent co-pathogen among the under-5 children in both sites. In urban sites, the percentage of V. cholerae along with co-existing ETEC and Campylobacter is changing in the last 20 years; Campylobacter (8.36%) and Enterotoxigenic Escherichia coli (ETEC) (7.15%) were the second and third most prevalent co-pathogens. Shigella (1.64%) was the second most common co-pathogen in the rural site. Azithromycin susceptibility increased slowly from 265 (8%) in 2006-2010 to 1485 (47.8%) in 2016-2021, and erythromycin susceptibility dropped substantially over 20 years period from 2,155 (98.4%) to 21 (0.9%). Tetracycline susceptibility decreased in the urban site from 2051 (45.9%) to 186 (4.2%) and ciprofloxacin susceptibility decreased from 2,581 (31.6%) to 1,360 (16.6%) until 2015, then increased 1,009 (22.6%) and 1,490 (18.2%) in 2016-2021, respectively. Since 2016, doxycycline showed 902 (100%) susceptibility. Clinicians need access to up-to-date information on antimicrobial susceptibility for treating hospitalized patients. To achieve the WHO-backed objective of eliminating cholera by 2030, the health systems need to be put under a proper surveillance system that may help to improve water and sanitation practices and deploy oral cholera vaccines strategically.
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Grants
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
- 1992-011 International Centre for Diarrhoeal Disease Research, Bangladesh
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Affiliation(s)
- Rina Das
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh.
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
| | - Sabiha Nasrin
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, 01003, USA
| | - Parag Palit
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Rukaeya Amin Sobi
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
| | - Al-Afroza Sultana
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
| | - Soroar Hossain Khan
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
| | - Md Ahshanul Haque
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
| | - Sharika Nuzhat
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
- James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh
- Department of Global Health, University of Washington, Seattle, WA, 98104, USA
| | - A S G Faruque
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
| | - Mohammod Jobayer Chisti
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sharani, Dhaka, 1212, Bangladesh
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Asumah MN, Padhi BK, Sinha A. Rising cases of cholera in Ethiopia: a need for sustainable wash practices? Int J Surg 2023; 109:608-609. [PMID: 37093098 PMCID: PMC10389514 DOI: 10.1097/js9.0000000000000196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 04/08/2023]
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20
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Zhou YY, Ma LY, Yu L, Lu X, Liang WL, Kan B, Su JR. Quinolone Resistance Genes and Their Contribution to Resistance in Vibrio cholerae Serogroup O139. Antibiotics (Basel) 2023; 12:antibiotics12020416. [PMID: 36830326 PMCID: PMC9952142 DOI: 10.3390/antibiotics12020416] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Quinolones are commonly used for reducing the duration of diarrhea, infection severity, and limiting further transmission of disease related to Vibrio cholerae, but V. cholerae susceptibility to quinolone decreases over time. In addition to mutations in the quinolone-resistance determining regions (QRDRs), the presence of qnr and other acquired genes also contributes to quinolone resistance. RESULTS We determined the prevalence of quinolone resistance related genes among V. cholerae O139 strains isolated in China. We determined that eight strains carried qnrVC, which encodes a pentapeptide repeat protein of the Qnr subfamily, the members of which protect topoisomerases from quinolone action. Four qnrVC alleles were detected: qnrVC1, qnrVC5, qnrVC12, and qnrVC9. However, the strains carrying qnrVC1, qnrVC5, and qnrVC12 were ciprofloxacin (CIP)-sensitive. Contrastingly, the strain carrying qnrVC9 demonstrated high CIP resistance. qnrVC9 was carried by a small plasmid, which was conjugative and contributed to the high CIP resistance to the receptor V. cholerae strain. The same plasmid was also detected in V. vulnificus. The qnrVC1, qnrVC5, and qnrVC12 were cloned into expression plasmids and conferred CIP resistance on the host V. cholerae O139 strain. CONCLUSIONS Our results revealed the contribution of quinolone resistance mediated by the qnrVC9 carried on the small plasmid and its active horizontal transfer among Vibrio species. The results also suggested the different effects of qnrVC alleles in different V. cholerae strains, which is possibly due to differences in sequences of qnrVC alleles and even the genetic characteristics of the host strains.
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Affiliation(s)
- Yan-Yan Zhou
- Department of Clinical Laboratory Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Li-Yan Ma
- Department of Clinical Laboratory Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Li Yu
- Beijing Municipal Center for Disease Prevention and Control, Beijing 100013, China
| | - Xin Lu
- Chinese Center for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Department of Diarrheal Diseases, National Institute for Communicable Disease Control and Prevention, Beijing 102206, China
| | - Wei-Li Liang
- Chinese Center for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Department of Diarrheal Diseases, National Institute for Communicable Disease Control and Prevention, Beijing 102206, China
| | - Biao Kan
- Chinese Center for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Department of Diarrheal Diseases, National Institute for Communicable Disease Control and Prevention, Beijing 102206, China
- Correspondence: (B.K.); (J.-R.S.); Tel.: +10-58900743 (B.K.); +10-63138545 (J.-R.S.)
| | - Jian-Rong Su
- Department of Clinical Laboratory Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- Correspondence: (B.K.); (J.-R.S.); Tel.: +10-58900743 (B.K.); +10-63138545 (J.-R.S.)
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21
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Malaeb D, Sallam M, Younes S, Mourad N, Sarray El Dine A, Obeid S, Hallit S, Hallit R. Knowledge, Attitude, and Practice in a Sample of the Lebanese Population Regarding Cholera. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316243. [PMID: 36498316 PMCID: PMC9735709 DOI: 10.3390/ijerph192316243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 05/12/2023]
Abstract
The evaluation of knowledge, attitude, and practices towards an emerging disease is an essential component of public health preventive measures during an outbreak. In October 2022, an outbreak of cholera was reported in Lebanon, which is the first to be reported in the Middle Eastern country for 30 years. This study aimed to explore the level of knowledge as well as attitude and practice of the general public in Lebanon towards cholera. A self-administered structured questionnaire was distributed via an online link to individuals living in Lebanon during October-November 2022. The survey instrument comprised items to assess the sociodemographic data; questions on knowledge about cholera symptoms, transmission, and prevention; as well as attitude and practice questions. Our study involved 553 participants, with a median age of 24 years and a majority of females (72.5%). The results showed that the majority of respondents correctly identified diarrhea as a symptom of cholera and recognized the spread via contaminated water and food. Having a university level education compared with secondary school or less (adjusted odds ratio (aOR) = 2.09), being married compared with single (aOR = 1.67), and working in the medical field compared with unemployed (aOR = 4.19) were significantly associated with higher odds of having good cholera knowledge. Having good knowledge compared with having a poor level of cholera knowledge (aOR = 1.83) and older age (aOR = 1.03) were significantly associated with higher odds of having a good attitude towards cholera. The current study showed an overall high knowledge score on cholera among the Lebanese population. Nevertheless, gaps in cholera knowledge were identified and should be addressed, particularly among workers in the medical field. Thus, we recommend targeted health education to the general population that aims to strengthen the health resilience in the community.
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Affiliation(s)
- Diana Malaeb
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
- Correspondence: (M.S.); (S.H.); Tel.: +962-79-184-5186 (M.S.)
| | - Samar Younes
- Department of Biomedical Sciences, School of Pharmacy, Lebanese International University, Bekaa, Lebanon
| | - Nisreen Mourad
- Pharmaceutical Sciences Department, School of Pharmacy, Lebanese International University, Bekaa, Lebanon
| | - Abir Sarray El Dine
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut P.O. Box 146404, Lebanon
| | - Sahar Obeid
- Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman 11931, Jordan
- Correspondence: (M.S.); (S.H.); Tel.: +962-79-184-5186 (M.S.)
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh P.O. Box 446, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame des Secours, University Hospital Center, Byblos, Lebanon
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Orata FD, Hussain NAS, Liang KYH, Hu D, Boucher YF. Genomes of Vibrio metoecus co-isolated with Vibrio cholerae extend our understanding of differences between these closely related species. Gut Pathog 2022; 14:42. [PMID: 36404338 PMCID: PMC9677704 DOI: 10.1186/s13099-022-00516-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/04/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Vibrio cholerae, the causative agent of cholera, is a well-studied species, whereas Vibrio metoecus is a recently described close relative that is also associated with human infections. The availability of V. metoecus genomes provides further insight into its genetic differences from V. cholerae. Additionally, both species have been co-isolated from a cholera-free brackish coastal pond and have been suggested to interact with each other by horizontal gene transfer (HGT). RESULTS The genomes of 17 strains from each species were sequenced. All strains share a large core genome (2675 gene families) and very few genes are unique to each species (< 3% of the pan-genome of both species). This led to the identification of potential molecular markers-for nitrite reduction, as well as peptidase and rhodanese activities-to further distinguish V. metoecus from V. cholerae. Interspecies HGT events were inferred in 21% of the core genes and 45% of the accessory genes. A directional bias in gene transfer events was found in the core genome, where V. metoecus was a recipient of three times (75%) more genes from V. cholerae than it was a donor (25%). CONCLUSION V. metoecus was misclassified as an atypical variant of V. cholerae due to their resemblance in a majority of biochemical characteristics. More distinguishing phenotypic assays can be developed based on the discovery of potential gene markers to avoid any future misclassifications. Furthermore, differences in relative abundance or seasonality were observed between the species and could contribute to the bias in directionality of HGT.
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Affiliation(s)
- Fabini D. Orata
- grid.17089.370000 0001 2190 316XDepartment of Biological Sciences, University of Alberta, Edmonton, Alberta Canada ,grid.17089.370000 0001 2190 316XDepartment of Chemical and Materials Engineering, University of Alberta, Edmonton, Alberta Canada
| | - Nora A. S. Hussain
- grid.17089.370000 0001 2190 316XDepartment of Biological Sciences, University of Alberta, Edmonton, Alberta Canada
| | - Kevin Y. H. Liang
- grid.17089.370000 0001 2190 316XDepartment of Biological Sciences, University of Alberta, Edmonton, Alberta Canada ,grid.14709.3b0000 0004 1936 8649Department of Quantitative Life Sciences, McGill University, Montréal, Québec Canada ,grid.14709.3b0000 0004 1936 8649Lady Davis Institute, Jewish General Hospital, McGill University, Montréal, Québec Canada
| | - Dalong Hu
- grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore and National University Hospital System, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Singapore Centre for Environmental Life Sciences Engineering, National University of Singapore, Singapore, Singapore
| | - Yann F. Boucher
- grid.17089.370000 0001 2190 316XDepartment of Biological Sciences, University of Alberta, Edmonton, Alberta Canada ,grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore and National University Hospital System, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Singapore Centre for Environmental Life Sciences Engineering, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Infectious Diseases Translational Research Program, Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore and National University Hospital System, Singapore, Singapore
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Sialubanje C, Kapina M, Chewe O, Matapo BB, Ngomah AM, Gianetti B, Ngosa W, Kasonde M, Musonda K, Mulenga M, Michelo C, Sinyange N, Bobo P, Zyambo K, Mazyanga L, Bakyaita N, Mukonka VM. Effectiveness of two doses of Euvichol-plus oral cholera vaccine in response to the 2017/2018 outbreak: a matched case-control study in Lusaka, Zambia. BMJ Open 2022; 12:e066945. [PMID: 36368745 PMCID: PMC9660660 DOI: 10.1136/bmjopen-2022-066945] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Zambia experienced a major cholera outbreak in 2017-2018, with more than 5905 cases reported countrywide, predominantly from the peri-urban slums of Lusaka city. The WHO recommends the use of oral cholera vaccines (OCVs) together with traditional control measures, including health promotion, provision of safe water and improving sanitation, in cholera endemic areas and during cholera outbreaks. In response to this outbreak, the Zambian government implemented the OVC campaign and administered the Euvichol-plus vaccine in the high-risk subdistricts of Lusaka. Although OCVs have been shown to be effective in preventing cholera infection in cholera endemic and outbreak settings, the effectiveness of the Euvichol-plus vaccine has not yet been evaluated in Zambia. This study aimed to determine the effectiveness of two doses of OCV administered during the 2017/2018 vaccination campaign. METHODS We conducted a matched case-control study involving 79 cases and 316 controls following the mass vaccination campaign in the four subdistricts of Lusaka (Chawama, Chipata, Kanyama and Matero). Matching of controls was based on the place of residence, age and sex. Conditional logistic regression was used for analysis. Adjusted OR (AOR), 95% CI and vaccine effectiveness (1-AOR) for two doses of Euvichol-plus vaccine and any dose were estimated (p<0.05). RESULTS The AOR vaccine effectiveness for two doses of Euvichol-plus OCV was 81.0% (95% CI 66.0% to 78.0%; p<0.01). Secondary analysis showed that vaccine effectiveness for any dose was 74.0% (95% CI 50.0% to 86.0%; p<0.01). CONCLUSION These findings show that two doses of Euvichol-plus OCV are effective in a cholera outbreak setting in Lusaka, Zambia. The findings also indicate that two doses are more effective than a single dose and thus support the use of two doses of the vaccine as part of an integrated intervention to cholera control during outbreaks.
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Affiliation(s)
- Cephas Sialubanje
- School of Public Health, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Muzala Kapina
- Zambia National Public Health Institute, Lusaka, Zambia
| | - Orbrie Chewe
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
- Ministry of health Zambia, Lusaka, Zambia
| | - Belem Blamwell Matapo
- World Health Organization, Lusaka, Zambia
- Disease Surveillance, World Health Organisation, Lusaka, Zambia
| | - Albertina Moraes Ngomah
- Communication Information & Research, Zambia National Public Health Institute, Lusaka, Zambia
| | | | - William Ngosa
- Communication Information & Research, Zambia National Public Health Institute, Lusaka, Zambia
| | - Mpanga Kasonde
- Laboratory System and Networks, Zambia National Public Health Institute, Lusaka, Zambia
| | - Kunda Musonda
- Ministry of health Zambia, Lusaka, Zambia
- Laboratory Systems and Networks, Zambia National Public Health Institute, Lusaka, Zambia
| | | | - C Michelo
- University of Zambia School of Public Health, Lusaka, Zambia
| | - Nyambe Sinyange
- Epidemic Preparedness & Response, Zambia National Public Health Institute, Lusaka, Zambia
| | | | | | - Lucy Mazyanga
- Zambia National Public Health Institute, Lusaka, Zambia
| | | | - Victor M Mukonka
- Zambia National Public Health Institute, Lusaka, Zambia
- The Copperbelt University School of Medicine, Kitwe, Zambia
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24
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Nasreen T, Islam MT, Liang KYH, Johura FT, Kirchberger PC, Hill E, Sultana M, Case RJ, Alam M, Boucher YF. Dynamic Subspecies Population Structure of Vibrio cholerae in Dhaka, Bangladesh. MICROBIAL ECOLOGY 2022; 84:730-745. [PMID: 34633491 DOI: 10.1007/s00248-021-01838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/02/2021] [Indexed: 06/13/2023]
Abstract
Cholera has been endemic to the Ganges Delta for centuries. Although the causative agent, Vibrio cholerae, is autochthonous to coastal and brackish water, cholera occurs continually in Dhaka, the inland capital city of Bangladesh which is surrounded by fresh water. Despite the persistence of this problem, little is known about the environmental abundance and distribution of lineages of V. cholerae, the most important being the pandemic generating (PG) lineage consisting mostly of serogroup O1 strains. To understand spatial and temporal dynamics of PG lineage and other lineages belonging to the V. cholerae species in surface water in and around Dhaka City, we used qPCR and high-throughput amplicon sequencing. Seven different freshwater sites across Dhaka were investigated for six consecutive months, and physiochemical parameters were measured in situ. Total abundance of V. cholerae was found to be relatively stable throughout the 6-month sampling period, with 2 × 105 to 4 × 105 genome copies/L at six sites and around 5 × 105 genome copies/L at the site located in the most densely populated part of Dhaka City. PG O1 V. cholerae was present in high abundance during the entire sampling period and composed between 24 and 92% of the total V. cholerae population, only showing occasional but sudden reductions in abundance. In instances where PG O1 lost its dominance, other lineages underwent a rapid expansion while the size of the total V. cholerae population remained almost unchanged. Intraspecies richness of V. cholerae was positively correlated with salinity, conductivity, and total dissolved solids (TDS), while it was negatively correlated with dissolved oxygen (DO) concentration in water. Interestingly, negative correlation was observed specifically between PG O1 and salinity, even though the changes in this variable were minor (0-0.8 ppt). Observations in this study suggest that at the subspecies level, population composition of naturally occurring V. cholerae can be influenced by fluctuations in environmental factors, which can lead to altered competition dynamics among the lineages.
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Affiliation(s)
- Tania Nasreen
- Department of Biological Sciences, University of Alberta, Edmonton, AB, T6G 2E9, Canada
| | | | - Kevin Y H Liang
- Department of Biological Sciences, University of Alberta, Edmonton, AB, T6G 2E9, Canada
| | - Fatema-Tuz Johura
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Paul C Kirchberger
- Department of Integrative Biology, University of Texas At Austin, Austin, TX, 78712, USA
| | - Eric Hill
- Saw Swee Hock School of Public Health, National University of Singapore and National University Hospital System, Singapore, Singapore
- Singapore Centre for Environmental Life Sciences Engineering (SCELSE), National University of Singapore, Singapore, Singapore
| | - Marzia Sultana
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rebecca J Case
- Department of Biological Sciences, University of Alberta, Edmonton, AB, T6G 2E9, Canada
| | - Munirul Alam
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Yann F Boucher
- Department of Biological Sciences, University of Alberta, Edmonton, AB, T6G 2E9, Canada.
- Saw Swee Hock School of Public Health, National University of Singapore and National University Hospital System, Singapore, Singapore.
- Singapore Centre for Environmental Life Sciences Engineering (SCELSE), National University of Singapore, Singapore, Singapore.
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Islam MT, Date K, Khan AI, Bhuiyan TR, Khan ZH, Ahmed S, Hossain M, Khaton F, Zaman K, McMillan NAJ, Anand A, An Q, Zhang C, Weldon WC, Yu A, Luby S, Qadri F. Co-administration of Oral Cholera Vaccine With Oral Polio Vaccine Among Bangladeshi Young Children: A Randomized Controlled Open Label Trial to Assess Interference. Clin Infect Dis 2022; 76:263-270. [PMID: 36136760 PMCID: PMC9839191 DOI: 10.1093/cid/ciac782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/19/2022] [Accepted: 09/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cholera remains a public health threat for low- and middle-income countries, particularly in Asia and Africa. Shanchol™, an inactivated oral cholera vaccine (OCV) is currently in use globally. OCV and oral poliovirus vaccines (OPV) could be administered concomitantly, but the immunogenicity and safety of coadministration among children aged 1-3 years is unknown. METHODS We undertook an open-label, randomized, controlled, inequality trial in Dhaka city, Bangladesh. Healthy children aged 1-3 years were randomly assigned to 1 of 3 groups: bivalent OPV (bOPV)-alone, OCV-alone, or combined bOPV + OCV and received vaccines on the day of enrollment and 28 days later. Blood samples were collected on the day of enrollment, day 28, and day 56. Serum poliovirus neutralizing antibodies and vibriocidal antibodies against Vibrio cholerae O1 were assessed using microneutralization assays. RESULTS A total of 579 children aged 1‒3 years were recruited, 193 children per group. More than 90% of the children completed visits at day 56. Few adverse events following immunization were recorded and were equivalent among study arms. On day 28, 60% (90% confidence interval: 53%-67%) and 54% (46%-61%) of participants with co-administration of bOPV + OCV responded to polioviruses type 1 and 3, respectively, compared to 55% (47%-62%) and 46% (38%-53%) in the bOPV-only group. Additionally, >50% of participants showed a ≥4-fold increase in vibriocidal antibody titer responses on day 28, comparable to the responses observed in OCV-only arm. CONCLUSIONS Co-administration of bOPV and OCV is safe and effective in children aged 1-3 years and can be cost-beneficial. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT03581734).
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Affiliation(s)
| | - Kashmira Date
- Current affiliation: Global Medical Affairs Lead for Vaccines, Global Public Health at Johnson & Johnson
| | - Ashraful Islam Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Taufiqur Rahman Bhuiyan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Zahid Hasan Khan
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shamim Ahmed
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Motaher Hossain
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Fatema Khaton
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - K Zaman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nigel A J McMillan
- Infectious Diseases and Immunology, Menzies Health Institute Queensland and School of Pharmacy and Medical Science, Griffith University, Gold Coast, Australia
| | - Abhijeet Anand
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Qian An
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Chenhua Zhang
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William C Weldon
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexander Yu
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Stephen Luby
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Firdausi Qadri
- Correspondence: F. Qadri, Mucosal Immunology and Vaccinology Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh ()
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26
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Elimian K, Yennan S, Musah A, Cheshi ID, King C, Dunkwu L, Mohammed AL, Ekeng E, Akande OW, Ayres S, Gandi B, Pembi E, Saleh F, Omar AN, Crawford E, Olopha OO, Nnaji R, Muhammad B, Luka-Lawal R, Ihueze AC, Olatunji D, Ojukwu C, Akinpelu AM, Adaga E, Abubakar Y, Nwadiuto I, Ngishe S, Alowooye AB, Nwogwugwu PC, Kamaldeen K, Abah HN, Chukwuebuka EH, Yusuff HA, Mamadu I, Mohammed AA, Peter S, Abbah OC, Oladotun PM, Oifoh S, Olugbile M, Agogo E, Ndodo N, Babatunde O, Mba N, Oladejo J, Ilori E, Alfvén T, Myles P, Ochu CL, Ihekweazu C, Adetifa I. Epidemiology, diagnostics and factors associated with mortality during a cholera epidemic in Nigeria, October 2020-October 2021: a retrospective analysis of national surveillance data. BMJ Open 2022; 12:e063703. [PMID: 36123095 PMCID: PMC9486350 DOI: 10.1136/bmjopen-2022-063703] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Nigeria reported an upsurge in cholera cases in October 2020, which then transitioned into a large, disseminated epidemic for most of 2021. This study aimed to describe the epidemiology, diagnostic performance of rapid diagnostic test (RDT) kits and the factors associated with mortality during the epidemic. DESIGN A retrospective analysis of national surveillance data. SETTING 33 of 37 states (including the Federal Capital Territory) in Nigeria. PARTICIPANTS Persons who met cholera case definition (a person of any age with acute watery diarrhoea, with or without vomiting) between October 2020 and October 2021 within the Nigeria Centre for Disease Control surveillance data. OUTCOME MEASURES Attack rate (AR; per 100 000 persons), case fatality rate (CFR; %) and accuracy of RDT performance compared with culture using area under the receiver operating characteristic curve (AUROC). Additionally, individual factors associated with cholera deaths and hospitalisation were presented as adjusted OR with 95% CIs. RESULTS Overall, 93 598 cholera cases and 3298 deaths (CFR: 3.5%) were reported across 33 of 37 states in Nigeria within the study period. The proportions of cholera cases were higher in men aged 5-14 years and women aged 25-44 years. The overall AR was 46.5 per 100 000 persons. The North-West region recorded the highest AR with 102 per 100 000. Older age, male gender, residency in the North-Central region and severe dehydration significantly increased the odds of cholera deaths. The cholera RDT had excellent diagnostic accuracy (AUROC=0.91; 95% CI 0.87 to 0.96). CONCLUSIONS Cholera remains a serious public health threat in Nigeria with a high mortality rate. Thus, we recommend making RDT kits more widely accessible for improved surveillance and prompt case management across the country.
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Affiliation(s)
- Kelly Elimian
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | - Anwar Musah
- Department of Risk and Disaster Reduction, University College London, London, UK
| | | | - Carina King
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | | | - Eme Ekeng
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Oluwatosin Wuraola Akande
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Stephanie Ayres
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | | | - Fatima Saleh
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | | | | | | | | | | | | | | | | | - Ene Adaga
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Yusuf Abubakar
- Zamfara State Ministry of Health, Zamfara State, Nigeria
| | | | - Samuel Ngishe
- Public Health, Ministry of Health, Benue State, Makurdi, Nigeria
| | | | | | | | | | | | | | - Ibrahim Mamadu
- World Health Organization Country Office for Nigeria, Abuja, Nigeria
| | | | - Sarah Peter
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | | | | | | | | | | | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - John Oladejo
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Puja Myles
- Clinical Practice Research Datalink, London, UK
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27
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Mostafavi E, Ghasemian A, Abdinasir A, Nematollahi Mahani SA, Rawaf S, Salehi Vaziri M, Gouya MM, Minh Nhu Nguyen T, Al Awaidy S, Al Ariqi L, Islam MM, Abu Baker Abd Farag E, Obtel M, Omondi Mala P, Matar GM, Asghar RJ, Barakat A, Sahak MN, Abdulmonem Mansouri M, Swaka A. Emerging and Re-emerging Infectious Diseases in the WHO Eastern Mediterranean Region, 2001-2018. Int J Health Policy Manag 2022; 11:1286-1300. [PMID: 33904695 PMCID: PMC9808364 DOI: 10.34172/ijhpm.2021.13] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/08/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Countries in the World Health Organization (WHO) Eastern Mediterranean Region (EMR) are predisposed to highly contagious, severe and fatal, emerging infectious diseases (EIDs), and re-emerging infectious diseases (RIDs). This paper reviews the epidemiological situation of EIDs and RIDs of global concern in the EMR between 2001 and 2018. METHODS To do a narrative review, a complete list of studies in the field was we prepared following a systematic search approach. Studies that were purposively reviewed were identified to summarize the epidemiological situation of each targeted disease. A comprehensive search of all published studies on EIDs and RIDs between 2001 and 2018 was carried out through search engines including Medline, Web of Science, Scopus, Google Scholar, and ScienceDirect. RESULTS Leishmaniasis, hepatitis A virus (HAV) and hepatitis E virus (HEV) are reported from all countries in the region. Chikungunya, Crimean Congo hemorrhagic fever (CCHF), dengue fever, and H5N1 have been increasing in number, frequency, and expanding in their geographic distribution. Middle East respiratory syndrome (MERS), which was reported in this region in 2012 is still a public health concern. There are challenges to control cholera, diphtheria, leishmaniasis, measles, and poliomyelitis in some of the countries. Moreover, Alkhurma hemorrhagic fever (AHF), and Rift Valley fever (RVF) are limited to some countries in the region. Also, there is little information about the real situation of the plague, Q fever, and tularemia. CONCLUSION EIDs and RIDs are prevalent in most countries in the region and could further spread within the region. It is crucial to improve regional capacities and capabilities in preventing and responding to disease outbreaks with adequate resources and expertise.
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Affiliation(s)
- Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Abdolmajid Ghasemian
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Abubakar Abdinasir
- Infectious Hazards Management, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt
| | - Seyed Alireza Nematollahi Mahani
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Salman Rawaf
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College, London, UK
| | - Mostafa Salehi Vaziri
- Department of Arboviruses and Viral Hemorrhagic Fevers, Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Mahdi Gouya
- Centre for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Tran Minh Nhu Nguyen
- Infectious Hazards Management, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt
| | | | - Lubna Al Ariqi
- Infectious Hazards Management, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt
| | - Md. Mazharul Islam
- Department of Animal Resources, Ministry of Municipality and Environment, Doha, Qatar
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | | | - Majdouline Obtel
- Laboratory of Community Medicine, Preventive Medicine and Hygiene, Public Health Department, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
- Laboratory of Epidemiology, Biostatistics and Clinical Research, Public Health Department, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Peter Omondi Mala
- Infectious Hazards Management, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt
| | - Ghassan M. Matar
- Department of Experimental Pathology, Immunology and Microbiology Center for Infectious Diseases Research, American University of Beirut & Medical Center, Beirut, Lebanon
| | - Rana Jawad Asghar
- University of Nebraska Medical Center, Omaha, NE, USA
- Global Health Strategists & Implementers (GHSI), Islamabad, Pakistan
| | - Amal Barakat
- Infectious Hazards Management, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt
| | - Mohammad Nadir Sahak
- Infectious Hazard Management Department, World Health Organization, Kabul, Afghanistan
| | - Mariam Abdulmonem Mansouri
- Communicable Diseases Control Department, Public Health Directorate Unit, Ministry of Health, Kuwait City, Kuwait
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Alexandra Swaka
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College, London, UK
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Santajit S, Kong-ngoen T, Tunyong W, Pumirat P, Ampawong S, Sookrung N, Indrawattana N. Occurrence, antimicrobial resistance, virulence, and biofilm formation capacity of Vibrio spp. and Aeromonas spp. isolated from raw seafood marketed in Bangkok, Thailand. Vet World 2022; 15:1887-1895. [PMID: 36185513 PMCID: PMC9394122 DOI: 10.14202/vetworld.2022.1887-1895] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Bacteria of the genera Vibrio and Aeromonas cause seafood-borne zoonoses, which may have a significant impact on food safety, economy, and public health worldwide. The presence of drug-resistant and biofilm-forming phenotypes in the food chain increases the risk for consumers. This study aimed to investigate the characteristics, virulence, biofilm production, and dissemination of antimicrobial-resistant pathogens isolated from seafood markets in Bangkok, Thailand.
Materials and Methods: A total of 120 retail seafood samples were collected from 10 local markets in Bangkok and peripheral areas. All samples were cultured and the Vibrio and Aeromonas genera were isolated using selective agar and biochemical tests based on standard protocols (ISO 21872-1: 2017). The antibiotic susceptibility test was conducted using the disk diffusion method. The presence of hemolysis and protease production was also investigated. Polymerase chain reaction (PCR) was used to determine the presence of the hlyA gene. Furthermore, biofilm formation was characterized by microtiter plate assay and scanning electron microscopy.
Results: The bacterial identification test revealed that 35/57 (61.4%) belonged to the Vibrio genus and 22/57 (38.6%) to the Aeromonas genus. The Kirby–Bauer test demonstrated that 61.4% of the isolates were resistant to at least one antibiotic and 45.61% had a high multiple antibiotic resistance index (≥0.2). PCR analysis indicated that 75.44% of the bacteria harbored the hlyA gene. Among them, 63.16% exhibited the hemolysis phenotype and 8.77% showed protease activity. The biofilm formation assay demonstrated that approximately 56.14% of all the isolates had the potential to produce biofilms. The moderate biofilm production was the predominant phenotype.
Conclusion: The results of this study provide evidence of the multiple drug resistance phenotype and biofilm formation capacity of Vibrio and Aeromonas species contaminating raw seafood. Effective control measures and active surveillance of foodborne zoonoses are crucial for food safety and to decrease the occurrence of diseases associated with seafood consumption.
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Affiliation(s)
- Sirijan Santajit
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, 80160, Thailand; Research Center in Tropical Pathobiology, Walailak University, Tha Sala, 80160, Thailand
| | - Thida Kong-ngoen
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Witawat Tunyong
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pornpan Pumirat
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Sumate Ampawong
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Nitat Sookrung
- Biomedical Research Incubator Unit, Department of Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nitaya Indrawattana
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Direct and Rapid Identification of Vibrio Cholerae Serogroup and Toxigenicity by a Novel Multiplex Real-Time Assay. Pathogens 2022; 11:pathogens11080865. [PMID: 36014986 PMCID: PMC9416260 DOI: 10.3390/pathogens11080865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 11/27/2022] Open
Abstract
Molecular diagnostic assays for cholera detection have superior sensitivity to conventional assays and are now being accepted as the new standard method, especially the real-time PCR/RT-PCR. However, limited throughput capacity and long detection duration prevent them from detecting more specimens and more targets in one turnaround time simultaneously. In this study, we utilized nucleic acid extraction-free, direct RT-PCR and high-speed amplification to develop a novel multiplex assay, a quadplex direct one-tube real-time RT-PCR assay, for rapid detection of the serogroup and cholera toxin toxigenicity of Vibrio cholerae targeting the epsM, ctxA, rfb-O1, and rfb-O139 genes. Performance of the multiplex assay was evaluated by comparison with the monoplex real-time PCR assay according to the China Cholera Prevention Manual. Detection data from clinical specimens showed that the new assay had good diagnostic sensitivities for epsM (100%, n = 301), ctxA (100%, n = 125), rfb-O1 (100%, n = 85), and rfb-O139 (97.87%, n = 49). Analysis of the analytical sensitivities with serial dilutions of positive standards showed that the detection limits of the new assay for Vibrio cholerae epsM,ctxA,rfb-O1, and rfb-O139 were up to 200, 590, 115, and 1052 copies per mL lower than the monoplex real-time PCR (910, 345, and 1616 copies/mL respectively, for ctxA,rfb-O1, and rfb-O139). The results indicate that the multiplex assay is a rapid, sensitive, specific, and easy-to-use detection tool for Vibrio cholerae, especially suitable for rapid identification and screening detection of mass specimens.
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30
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Liu Y, Xu T, Wang Q, Huang J, Zhu Y, Liu X, Liu R, Yang B, Zhou K. Vibrio cholerae senses human enteric α-defensin 5 through a CarSR two-component system to promote bacterial pathogenicity. Commun Biol 2022; 5:559. [PMID: 35676416 PMCID: PMC9178039 DOI: 10.1038/s42003-022-03525-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/23/2022] [Indexed: 11/09/2022] Open
Abstract
Vibrio cholerae (V. cholerae) is an aquatic bacterium responsible for acute and fatal cholera outbreaks worldwide. When V. cholerae is ingested, the bacteria colonize the epithelium of the small intestine and stimulate the Paneth cells to produce large amounts of cationic antimicrobial peptides (CAMPs). Human defensin 5 (HD-5) is the most abundant CAMPs in the small intestine. However, the role of the V. cholerae response to HD-5 remains unclear. Here we show that HD-5 significantly upregulates virulence gene expression. Moreover, a two-component system, CarSR (or RstAB), is essential for V. cholerae virulence gene expression in the presence of HD-5. Finally, phosphorylated CarR can directly bind to the promoter region of TcpP, activating transcription of tcpP, which in turn activates downstream virulence genes to promote V. cholerae colonization. In conclusion, this study reveals a virulence-regulating pathway, in which the CarSR two-component regulatory system senses HD-5 to activate virulence genes expression in V. cholerae.
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Affiliation(s)
- Yutao Liu
- TEDA Institute of Biological Sciences and Biotechnology, TEDA, Nankai University, Tianjin, PR China
| | - Tingting Xu
- The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen Institute of Respiratory Diseases, Shenzhen, Guangdong, PR China
| | - Qian Wang
- TEDA Institute of Biological Sciences and Biotechnology, TEDA, Nankai University, Tianjin, PR China
| | - Junxi Huang
- The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen Institute of Respiratory Diseases, Shenzhen, Guangdong, PR China
| | - Yangfei Zhu
- The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Laboratory Department, Shenzhen People's Hospital, Shenzhen, Guangdong, PR China
| | - Xingmei Liu
- TEDA Institute of Biological Sciences and Biotechnology, TEDA, Nankai University, Tianjin, PR China
| | - Ruiying Liu
- TEDA Institute of Biological Sciences and Biotechnology, TEDA, Nankai University, Tianjin, PR China
| | - Bin Yang
- TEDA Institute of Biological Sciences and Biotechnology, TEDA, Nankai University, Tianjin, PR China.
| | - Kai Zhou
- The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen Institute of Respiratory Diseases, Shenzhen, Guangdong, PR China.
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Muleya B, Mwaanga P, Daka PS, Nguvulu A. Potential cancer risk estimates from trihalomethanes in peri-urban settings of Kawama East of Mufulira, Zambia. JOURNAL OF WATER AND HEALTH 2022; 20:946-961. [PMID: 35768969 DOI: 10.2166/wh.2022.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In this study, we report the formation and cancer risk estimation of trihalomethanes (THMs) emanating from 'ex-situ' chlorination of shallow hand-dug well water obtained from a peri-urban area of Mufulira District, Zambia. The aim of the study was to evaluate the potential cancer risks for people in this area where chlorine water disinfection at the household level is commonly practiced. Water samples from 13 randomly selected hand-dug wells (4-8 m deep) were collected and analyzed for pH, turbidity, and dissolved organic carbon before chlorination. Then another set of water samples from the same 13 wells was chlorinated using the methods commonly practiced in this area, consistent with WHO recommended doses. The chlorination degradation products, THMs, trichloromethane, bromodichloromethane (CHCl2Br), dibromochloromethane (CHClBr2), and tribromomethane, were determined at three different times of 60, 180, and 300 min after chlorination, while residual chlorine was determined immediately after chlorination and at 60 and 1,440 min after chlorination. THMs were determined using gas chromatography (GC), while residual chlorine was determined colorimetrically. Then cancer risk estimation from ingestion, inhalation, and dermal routes was carried out. All water samples from the 13 wells showed elevated amounts of THMs, which also increased with increasing contact time. For instance, the concentrations of THMs at 60 min after chlorination ranged from 24.3 ± 2.0 to 61.3 ± 1.0 μg/L, while at 180 and 300 min, ranged between 85.6 ± 4.3-146.9 ± 2.5 μg/L and 188.1 ± 7.1-250.1 ± 7.1 μg/L, respectively. It was observed that tribromomethane was not detected at all in all samples, while CHCl2Br and CHClBr2 were only detected at 180 and 300 min post chlorination. The lifetime cancer risk estimation results showed negligible risk at 60 min post chlorination. However, at 180 and 300 min post chlorination, the results were far above negligible, but within the regulatory US EPA limits. The overall risk, however, could not be ignored, given a multiplicity of exposure to various other contaminants, raising concerns over additivity and synergistic interactive effects, particularly for non-cancer hazard indices.
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Affiliation(s)
- Benson Muleya
- Department of Analytical Services, Mopani Copper Mines Plc, Mufulira Mine Site, Mufulira, Zambia
| | - Phenny Mwaanga
- Department of Environmental Engineering, Copperbelt University, Kitwe, Zambia E-mail:
| | - Philip S Daka
- Department of Chemistry, Copperbelt University, Kitwe, Zambia
| | - Alick Nguvulu
- Department of Geomatics Engineering, Copperbelt University, Kitwe, Zambia
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Ahmad Zamri N, Rusli MEF, Mohamad Yusof L, Rosli R. Immunization with a bicistronic DNA vaccine modulates systemic IFN-γ and IL-10 expression against Vibrio cholerae infection. J Med Microbiol 2022; 71. [PMID: 35635780 DOI: 10.1099/jmm.0.001536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Cholera is an acute enteric infection caused by Vibrio cholerae, particularly in areas lacking access to clean water. Despite the global effort to improve water quality in these regions, the burden of cholera in recent years has not yet declined. Interest has therefore extended in the use of bicistronic DNA vaccine encoding ctxB and tcpA genes of V. cholerae as a potential vaccine.Hypothesis/Gap Statement. The potential of a bicistronic DNA vaccine, pVAX-ctxB-tcpA has not been determined in vitro and in vivo.Aim. The goal of present study was to evaluate in vitro expression and in vivo potential of pVAX-ctxB-tcpA vaccine against V. cholerae.Methodology. The pVAX-ctxB-tcpA was transiently transfected into mammalian COS-7 cells, and the in vitro expression was assessed using fluorescence and Western blot analyses. Next, the vaccine was encapsulated into sodium alginate using water-in-oil emulsification and evaluated for its efficiency in different pH conditions. Subsequently, oral vaccination using en(pVAX-ctxB-tcpA) was performed in vivo. The animals were challenged with V. cholerae O1 El Tor after 2 weeks of vaccination using the Removable Intestinal Tie-Adult Rabbit Diarrhoea (RITARD) model. Following the infection challenge, the rabbits were monitored for evidence of symptoms, and analysed for systemic cytokine expression level (TNF-α, IFN-γ, IL-6 and IL-10) using quantitative real-time polymerase chain reaction.Results. The in vitro expression of pVAX-ctxB-tcpA was successfully verified via fluorescence and Western blot analyses. Meanwhile, in vivo analysis demonstrated that the en(pVAX-ctxB-tcpA) was able to protect the RITARD model against V. cholerae infection due to a lack of evidence on the clinical manifestations of cholera following bacterial challenge. Furthermore, the bicistronic group showed an upregulation of systemic IFN-γ and IL-10 following 12 days of vaccination, though not significant, suggesting the possible activation of both T-helper 1 and 2 types of response. However, upon bacterial challenge, the gene expression of all cytokines did not change.Conclusion. Our findings suggest that the bicistronic plasmid DNA vaccine, pVAX-ctxB-tcpA, showed a potential role in inducing immune response against cholera through upregulation of in vitro gene and protein expression as well as in vivo cytokine gene expression, particularly IFN-γ and IL-10.
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Affiliation(s)
- Najwa Ahmad Zamri
- Medical Genetics Laboratory, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Muhammad Ehsan Fitri Rusli
- Medical Genetics Laboratory, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Loqman Mohamad Yusof
- Department of Companion Animal and Surgery, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Rozita Rosli
- Medical Genetics Laboratory, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Exploring Blue Spaces' Effects on Childhood Leukaemia Incidence: A Population-Based Case-Control Study in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095232. [PMID: 35564626 PMCID: PMC9103937 DOI: 10.3390/ijerph19095232] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
Abstract
Background: Blue spaces have been a key part of human evolution, providing resources and helping economies develop. To date, no studies have been carried out to explore how they may be linked to paediatric oncological diseases. Objectives: To explore the possible relationship of residential proximity to natural and urban blue spaces on childhood leukaemia. Methods: A population-based case–control study was conducted in four regions of Spain across the period 2000–2018. A total of 936 incident cases and 5616 controls were included, individually matched by sex, year of birth and place of residence. An exposure proxy with four distances (250 m, 500 m, 750 m, and 1 km) to blue spaces was built using the geographical coordinates of the participants’ home residences. Odds ratios (ORs) and 95% confidence intervals (95%CIs) for blue-space exposure were calculated for overall childhood leukaemia, and the acute lymphoblastic (ALL) and acute myeloblastic leukaemia (AML) subtypes, with adjustment for socio-demographic and environmental covariates. Results: A decrease in overall childhood leukaemia and ALL-subtype incidence was found as we came nearer to children’s places of residence, showing, for the study as a whole, a reduced incidence at 250 m (odds ratio (OR) = 0.77; 95%CI = 0.60–0.97), 500 m (OR = 0.78; 95%CI = 0.65–0.93), 750 m (OR = 0.80; 95%CI = 0.69–0.93), and 1000 m (OR = 0.84; 95%CI = 0.72–0.97). AML model results showed an increasing incidence at closest to subjects’ homes (OR at 250m = 1.06; 95%CI=0.63–1.71). Conclusions: Our results suggest a possible association between lower childhood leukaemia incidence and blue-space proximity. This study is a first approach to blue spaces’ possible effects on childhood leukaemia incidence; consequently, it is necessary to continue studying these spaces—while taking into account more individualised data and other possible environmental risk factors.
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Meki CD, Ncube EJ, Voyi K. Community-level interventions for mitigating the risk of waterborne diarrheal diseases: a systematic review. Syst Rev 2022; 11:73. [PMID: 35436979 PMCID: PMC9016942 DOI: 10.1186/s13643-022-01947-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Waterborne diarrhea diseases are among the leading causes of morbidity and mortality globally. These diseases can be mitigated by implementing various interventions. We reviewed the literature to identify available interventions to mitigate the risk of waterborne diarrheal diseases. METHODS We conducted a systematic database review of CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, Web of Science Core Collection, Cochrane library, Scopus, African Index Medicus (AIM), and LILACS (Latin American and Caribbean Health Sciences Literature). Our search was limited to articles published between 2009 and 2020. We conducted the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement checklist. The identified studies were qualitatively synthesized. RESULTS Our initial search returned 28 773 articles of which 56 studies met the inclusion criteria. The included studies reported interventions, including vaccines for rotavirus disease (monovalent, pentavalent, and Lanzhou lamb vaccine); enhanced water filtration for preventing cryptosporidiosis, Vi polysaccharide for typhoid; cholera 2-dose vaccines, water supply, water treatment and safe storage, household disinfection, and hygiene promotion for controlling cholera outbreaks. CONCLUSION We retrieved few studies on interventions against waterborne diarrheal diseases in low-income countries. Interventions must be specific to each type of waterborne diarrheal disease to be effective. Stakeholders must ensure collaboration in providing and implementing multiple interventions for the best outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020190411 .
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Affiliation(s)
- Chisala D Meki
- University of Zambia, School of Public Health, University of Zambia, P O. BOX 50110, Lusaka, Zambia. .,School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | - Esper J Ncube
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.,Rand Water, Johannesburg, South Africa
| | - Kuku Voyi
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Ritter PI, Sanchez RA. The effects of an epidemic on prenatal investments, childhood mortality and health of surviving children. JOURNAL OF POPULATION ECONOMICS 2022; 36:505-544. [PMID: 35378850 PMCID: PMC8968331 DOI: 10.1007/s00148-022-00886-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
The potential death toll from an epidemic is larger than the number of deaths directly associated with the infection. In this study, we find that prenatal exposure to a cholera epidemic in Peru increased childhood mortality and that surviving children were more likely to be underweight and to suffer from diarrhea. We further find that a significant part of this mortality happened during the first day of life, and that prenatal exposure to cholera decreased prenatal care and institutional deliveries, suggesting that the mortality and possibly other longer-term effects were partially driven by a reduction in prenatal investments.
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Charnley GEC, Kelman I, Gaythorpe KAM, Murray KA. Accessing sub-national cholera epidemiological data for Nigeria and the Democratic Republic of Congo during the seventh pandemic. BMC Infect Dis 2022; 22:288. [PMID: 35351008 PMCID: PMC8966316 DOI: 10.1186/s12879-022-07266-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vibrio cholerae is a water-borne pathogen with a global burden estimate at 1.4 to 4.0 million annual cases. Over 94% of these cases are reported in Africa and more research is needed to understand cholera dynamics in the region. Cholera data are lacking, mainly due to reporting issues, creating barriers for widespread research on cholera epidemiology and management in Africa. MAIN BODY Here, we present datasets that were created to help address this gap, collating freely available sub-national cholera data for Nigeria and the Democratic Republic of Congo. The data were collated from a variety of English and French publicly available sources, including the World Health Organization, PubMed, UNICEF, EM-DAT, the Nigerian CDC and peer-reviewed literature. These data include information on cases, deaths, age, gender, oral cholera vaccination, risk factors and interventions. CONCLUSION These datasets can facilitate qualitative, quantitative and mixed methods research in these two high burden countries to assist in public health planning. The data can be used in collaboration with organisations in the two countries, which have also collected data or undertaking research. By making the data and methods available, we aim to encourage their use and further data collection and compilation to help improve the data gaps for cholera in Africa.
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Affiliation(s)
- Gina E. C. Charnley
- grid.7445.20000 0001 2113 8111School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG UK
| | - Ilan Kelman
- grid.83440.3b0000000121901201Institute for Global Health & Institute for Risk and Disaster Reduction, University College London, London, WC1E 6BT UK ,grid.23048.3d0000 0004 0417 6230University of Agder, Kristiansand, Norway
| | - Katy A. M. Gaythorpe
- grid.7445.20000 0001 2113 8111Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, W2 1PG UK
| | - Kris A. Murray
- grid.7445.20000 0001 2113 8111Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, W2 1PG UK ,MRC Unit the Gambia at London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia
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Rashidijahanabad Z, Kelly M, Kamruzzaman M, Qadri F, Bhuiyan TR, McFall-Boegeman H, Wu D, Piszczek G, Xu P, Ryan ET, Huang X. Virus-like Particle Display of Vibrio choleraeO-Specific Polysaccharide as a Potential Vaccine against Cholera. ACS Infect Dis 2022; 8:574-583. [PMID: 35170309 PMCID: PMC9119010 DOI: 10.1021/acsinfecdis.1c00585] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Vibrio cholerae, a noninvasive mucosal pathogen, is endemic in more than 50 countries. Oral cholera vaccines, based on killed whole-cell strains of Vibrio cholerae, can provide significant protection in adults and children for 2-5 years. However, they have relatively limited direct protection in young children. To overcome current challenges, in this study, a potential conjugate vaccine was developed by linking O-specific polysaccharide (OSP) antigen purified from V. cholerae O1 El Tor Inaba strain PIC018 with Qβ virus-like particles efficiently via squarate chemistry. The Qβ-OSP conjugate was characterized with mass photometry (MP) on the whole particle level. Pertinent immunologic display of OSP was confirmed by immunoreactivity of the conjugate with convalescent phase samples from humans with cholera. Mouse immunization with the Qβ-OSP conjugate showed that the construct generated prominent and long-lasting IgG antibody responses against OSP, and the resulting antibodies could recognize the native lipopolysaccharide from Vibrio cholerae O1 Inaba. This was the first time that Qβ was conjugated with a bacterial polysaccharide for vaccine development, broadening the scope of this powerful carrier.
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Affiliation(s)
- Zahra Rashidijahanabad
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, United States.,Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, Michigan 48824, United States
| | - Meagan Kelly
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
| | - Mohammad Kamruzzaman
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Taufiqur R Bhuiyan
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Hunter McFall-Boegeman
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, United States.,Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, Michigan 48824, United States
| | - Di Wu
- Biophysics Core Facility, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Grzegorz Piszczek
- Biophysics Core Facility, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Peng Xu
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892, United States
| | - Edward T Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts 02114, United States.,Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, United States.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Xuefei Huang
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, United States.,Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, Michigan 48824, United States.,Department of Biomedical Engineering, Michigan State University, East Lansing, Michigan 48824, United States
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Saha P, Banerjee A, Banerjee G, Bag PK. Inhibitory activities of Typhonium trilobatum (L.) Schott on virulence potential of multi-drug resistant toxigenic Vibrio cholerae. Microb Pathog 2022; 165:105485. [DOI: 10.1016/j.micpath.2022.105485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/11/2022] [Accepted: 03/11/2022] [Indexed: 11/29/2022]
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Charnley GEC, Kelman I, Murray KA. Drought-related cholera outbreaks in Africa and the implications for climate change: a narrative review. Pathog Glob Health 2022; 116:3-12. [PMID: 34602024 PMCID: PMC8812730 DOI: 10.1080/20477724.2021.1981716] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Africa has historically seen several periods of prolonged and extreme droughts across the continent, causing food insecurity, exacerbating social inequity and frequent mortality. A known consequence of droughts and their associated risk factors are infectious disease outbreaks, which are worsened by malnutrition, poor access to water, sanitation and hygiene and population displacement. Cholera is a potential causative agent of such outbreaks. Africa has the highest global cholera burden, several drought-prone regions and high levels of inequity. Despite this, research on cholera and drought in Africa is lacking. Here, we review available research on drought-related cholera outbreaks in Africa and identify a variety of potential mechanisms through which these outbreaks occurred, including poor access to water, marginalization of refugees and nomadic populations, expansion of informal urban settlements and demographic risks. Future climate change may alter precipitation, temperature and drought patterns, resulting in more extremes, although these changes are likely to be spatially heterogeneous. Despite high uncertainty in future drought projections, increases in drought frequency and/or durations have the potential to alter these related outbreaks into the future, potentially increasing cholera burden in the absence of countermeasures (e.g. improved sanitation infrastructure). To enable effective planning for a potentially more drought-prone Africa, inequity must be addressed, research on the health implications of drought should be enhanced, and better drought diplomacy is required to improve drought resilience under climate change.
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Affiliation(s)
- Gina E. C. Charnley
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Ilan Kelman
- University of Agder, Kristiansand, Norway
- Institute for Global Health, Faculty of Population Health, University College London, London, UK
- Institute for Risk and Disaster Reduction, Faculty of Mathematical and Physical Sciences, University College London, London, UK
| | - Kris A. Murray
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- Mrc Unit the Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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Samuel Amoo O, Awoderu O, Yisau J, Oladele D, David AN, Raheem T, Uwandu M, Bamidele M, Fesobi TW, AbdusSalam A, Nduaga S, Oparaugo CT, Ajayi M, Ogbonna F, Musa AZ, Adedeji A, Ige F, Ihemanma O, Nuhu B, Okebugwu U, Bello IW, Onuigbo TI, Ikemefuna AS, Oraegbu JI, Agboola H, Idris J, Ajayi A, Salako BL, Smith SI. Assessment of potential factors that support the endemicity of cholera in Nigeria from food handlers, health workers and the environment. MICROBIOLOGIA MEDICA 2021. [DOI: 10.4081/mm.2021.10058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and Aims: Diarrheal diseases caused by bacterial pathogens are widespread and they result in morbidity and mortality of a lot of people yearly. The aim of this study was to assess the role of the environment, health workers and food handlers as reservoirs of Vibrio cholerae, and other diarrhea causing bacteria. Methods: Healthcare workers were proportionally selected and multistage sampling technique was adopted in selecting food handlers for the study. A total of 374 participants consisting of health workers and food handlers were recruited. Socio-demographic and clinical information were collected using questionnaires, while stool and environmental samples were also collected. Results: More female 55.9 % than male 44.1 % participated in the study and the mean age of participants was 38.7 ± 10.9. A significant number of participants identified poor hygiene practices as the major cause of diarrhea. V. cholerae O1 serotype was not detected in any of the environmental samples nor stool samples of both food handlers and health workers. However, V. cholerae (Non O1/Non O139) was isolated from the stool samples of food handlers and health workers in Kano State implying that they could be serving a source of the continuous dissemination of the pathogen. Other bacterial pathogens that are aetiology of diarrhea including Salmonella spp. Escherichia coli, Klebsiella oxytoca, and Enterobacter spp. were also isolated. Conclusion: It is therefore imperative that food handlers and health workers undergo periodic health checks to ensure they are free of pathogens they could easily transmit through food or to patients.
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Hegde ST, Lee EC, Islam Khan A, Lauer SA, Islam MT, Rahman Bhuiyan T, Lessler J, Azman AS, Qadri F, Gurley ES. Clinical Cholera Surveillance Sensitivity in Bangladesh and Implications for Large-Scale Disease Control. J Infect Dis 2021; 224:S725-S731. [PMID: 34453539 PMCID: PMC8687068 DOI: 10.1093/infdis/jiab418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background A surveillance system that is sensitive to detecting high burden areas is critical for achieving widespread disease control. In 2014, Bangladesh established a nationwide, facility-based cholera surveillance system for Vibrio cholerae infection. We sought to measure the sensitivity of this surveillance system to detect cases to assess whether cholera elimination targets outlined by the Bangladesh national control plan can be adequately measured. Methods We overlaid maps of nationally representative annual V cholerae seroincidence onto maps of the catchment areas of facilities where confirmatory laboratory testing for cholera was conducted, and we identified its spatial complement as surveillance greyspots, areas where cases likely occur but go undetected. We assessed surveillance system sensitivity and changes to sensitivity given alternate surveillance site selection strategies. Results We estimated that 69% of Bangladeshis (111.7 million individuals) live in surveillance greyspots and that 23% (25.5 million) of these individuals live in areas with the highest V cholerae infection rates. Conclusions The cholera surveillance system in Bangladesh has the ability to monitor progress towards cholera elimination goals among 31% of the country’s population, which may be insufficient for accurately measuring progress. Increasing surveillance coverage, particularly in the highest risk areas, should be considered.
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Affiliation(s)
- Sonia T Hegde
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elizabeth C Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Stephen A Lauer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Justin Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrew S Azman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Emily S Gurley
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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RecA gene genetic diversity and its regulatory element analysis: The case of Vibrio cholerae. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Uwishema O, Okereke M, Onyeaka H, Hasan MM, Donatus D, Martin Z, Oluwatomisin LA, Mhanna M, Olumide AO, Sun J, Adanur I. Threats and outbreaks of cholera in Africa amidst COVID-19 pandemic: a double burden on Africa's health systems. Trop Med Health 2021; 49:93. [PMID: 34819175 PMCID: PMC8611385 DOI: 10.1186/s41182-021-00376-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/01/2021] [Indexed: 12/16/2022] Open
Abstract
Every year, about 4 million cases and 143,000 deaths due to cholera are recorded globally, of which 54% were from Africa, reported in 2016. The outbreak and spread of cholera have risen exponentially particularly in Africa. Coupled with the recent emergence of the Coronavirus Pandemic (COVID-19) in Africa, the local health systems are facing a double burden of these infectious diseases due to their cumulative impact. In this paper, we evaluate the dual impact of cholera and COVID-19 in Africa and suggest plausible interventions that can be put in place to cushion its impact.
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Affiliation(s)
- Olivier Uwishema
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda. .,Clinton Global Initiative University, New York, USA. .,Faculty of Medicine, Karadeniz Technical University, 61080, Trabzon, Turkey.
| | - Melody Okereke
- Faculty of Pharmaceutical Sciences, University of Ilorin, Kwara State, Nigeria
| | - Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, 1902, Bangladesh
| | - Deocles Donatus
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,University of Dar es salaam Tanzania, Dar es Salaam, Tanzania
| | - Zebadiah Martin
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Mbeya Zonal Consultant Hospital, Mbeya, Tanzania
| | - Lawal Abdulwahab Oluwatomisin
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Department of Surgery, University of Ilorin Teaching Hospital, Kwara State, Nigeria
| | - Melissa Mhanna
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Faculty of Medicine, University of Saint Joseph Beirut, Beirut, Lebanon
| | - Adesipe Olaoluwa Olumide
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Department of Obstetrics and Gynaecology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Jeffrey Sun
- Clinton Global Initiative University, New York, USA.,Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Irem Adanur
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Faculty of Medicine, Karadeniz Technical University, 61080, Trabzon, Turkey
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Exploring relationships between drought and epidemic cholera in Africa using generalised linear models. BMC Infect Dis 2021; 21:1177. [PMID: 34809609 PMCID: PMC8609751 DOI: 10.1186/s12879-021-06856-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background Temperature and precipitation are known to affect Vibrio cholerae outbreaks. Despite this, the impact of drought on outbreaks has been largely understudied. Africa is both drought and cholera prone and more research is needed in Africa to understand cholera dynamics in relation to drought. Methods Here, we analyse a range of environmental and socioeconomic covariates and fit generalised linear models to publicly available national data, to test for associations with several indices of drought and make cholera outbreak projections to 2070 under three scenarios of global change, reflecting varying trajectories of CO2 emissions, socio-economic development, and population growth. Results The best-fit model implies that drought is a significant risk factor for African cholera outbreaks, alongside positive effects of population, temperature and poverty and a negative effect of freshwater withdrawal. The projections show that following stringent emissions pathways and expanding sustainable development may reduce cholera outbreak occurrence in Africa, although these changes were spatially heterogeneous. Conclusions Despite an effect of drought in explaining recent cholera outbreaks, future projections highlighted the potential for sustainable development gains to offset drought-related impacts on cholera risk. Future work should build on this research investigating the impacts of drought on cholera on a finer spatial scale and potential non-linear relationships, especially in high-burden countries which saw little cholera change in the scenario analysis. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06856-4.
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Scalable production and immunogenicity of a cholera conjugate vaccine. Vaccine 2021; 39:6936-6946. [PMID: 34716040 PMCID: PMC8609181 DOI: 10.1016/j.vaccine.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/05/2021] [Accepted: 10/05/2021] [Indexed: 11/26/2022]
Abstract
There is a need to develop cholera vaccines that are protective in young children under 5 years of age, which induce long-term immunity, and which can be incorporated into the Expanded Programme of Immunization (EPI) in cholera-endemic countries. The degree of protection afforded by currently available oral cholera vaccines (OCV) to young children is significantly lower than that induced by vaccination of older vaccine recipients. Immune responses that protect against cholera target the O-specific polysaccharide (OSP) of Vibrio cholerae, and young children have poor immunological responses to bacterial polysaccharides, which are T cell independent antigens. To overcome this, we have developed a cholera conjugate vaccine (CCV) containing the OSP of V. cholerae O1, the main cause of endemic and epidemic cholera. Here, we describe production of CCV through a scalable manufacturing process and preclinical evaluation of immunogenicity in the presence and absence of aluminum phosphate (alum) as an adjuvant. The vaccine displays V. cholerae O1 Inaba OSP in sun-burst display via single point attachment of core oligosaccharide to a recombinant tetanus toxoid heavy chain fragment (rTTHc). Two different pilot-scale production batches of non-GMP CCV were manufactured and characterized in terms of physico-chemical properties and immunogenicity. In preclinical testing, the vaccine induced OSP- and lipopolysaccharide (LPS)-specific IgG and IgM responses, vibriocidal responses, memory B cell responses, and protection in a V. cholerae O1 challenge model. The addition of alum to the administered vaccine increased OSP-specific immune responses. These results support evaluation of CCV in humans.
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Jedwab R, Khan AM, Russ J, Zaveri ED. Epidemics, pandemics, and social conflict: Lessons from the past and possible scenarios for COVID-19. WORLD DEVELOPMENT 2021; 147:105629. [PMID: 34866756 PMCID: PMC8633882 DOI: 10.1016/j.worlddev.2021.105629] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 06/02/2023]
Abstract
Since COVID-19 broke out, there has been renewed interest in understanding the economic and social dynamics of historical and more recent epidemics and pandemics, from the plagues of Antiquity to modern-day outbreaks like Ebola. These events can have significant impacts on the interplay between poverty and social cohesion, i.e. how different groups in society interact and cooperate to survive and prosper. To that effect, this paper provides a theory-driven overview of how social responses to past epidemics and pandemics were determined by the epidemiological and non-epidemiological characteristics of these outbreaks, with a particular focus on the conditions giving rise to scapegoating and persecution of minority groups, including migrants. We discuss existing theories as well as historical and quantitative studies, and highlight the cases where epidemics and pandemics may lead to milder or more severe forms of scapegoating. Finally, we conclude with a summary of priorities for future research on epidemics, pandemics and social conflict and discuss the possible effects and policy implications of COVID-19.
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Affiliation(s)
- Remi Jedwab
- George Washington University, Elliott School of International Affairs, 603 North Henry St, Alexandria, VA 22314, USA
| | - Amjad M Khan
- George Washington University, Elliott School of International Affairs, 603 North Henry St, Alexandria, VA 22314, USA
| | - Jason Russ
- George Washington University, Elliott School of International Affairs, 603 North Henry St, Alexandria, VA 22314, USA
| | - Esha D Zaveri
- George Washington University, Elliott School of International Affairs, 603 North Henry St, Alexandria, VA 22314, USA
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Sarker MHR, Moriyama M, Rahman MM, Das SK, Uzzaman MN, Das J, Uddin A, Banu S, Khan SH, Shahid ASMSB, Shahunja KM, Chisti MJ, Faruque ASG, Ahmed T. Characteristics of Rotavirus, ETEC, and Vibrio Cholerae Among Under 2-year Children Attending an Urban Diarrheal Disease Hospital in Bangladesh. J Prim Care Community Health 2021; 12:21501327211049118. [PMID: 34632833 PMCID: PMC8512248 DOI: 10.1177/21501327211049118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Information on comparative clinical and host characteristics of under-2
children with watery diarrhea caused by rotavirus, Enterotoxigenic
Escherichia coli (ETEC), and Vibrio cholerae
as single pathogens is lacking. We sought to investigate the
sociodemographic, clinical, and host characteristics of under-2 children
hospitalized due to these pathogens. Methodology We conducted a hospital-based case-control study using the icddr,b Diarrheal
Diseases Surveillance System. Children of either sex, <2 years with
diarrhea, who attended the hospital during 2014 to 2018, constituted the
study population. Stool specimens having a single pathogen like rotavirus,
ETEC, or Vibrio cholerae constituted the cases and stool
specimens having no detectable common enteropathogens comprised the
controls. Multinomial logistic regression analysis was done where control
was the reference group. Results A total of 14 889 patients were enrolled, 6939 of whom were under-2 children,
and 5245 (76%) constituted our study population. Among them 48% (n = 2532),
3% (n = 148) and 1% (n = 49) had rotavirus, ETEC, and Vibrio
cholera, respectively. A control group (diarrhea without these
3 or Shigella, Salmonella,
Aeromonas) accounted for 48% (n = 2516). In multinomial
regression model, children with rotavirus (adjusted odds ratio [aOR], 1.36;
95% confidence interval [95% CI], 1.19-1.55) less often presented with
dehydrating diarrhea compared to those with ETEC (aOR, 1.54; 95% CI,
1.05-2.26) and cholera (aOR, 2.25; 95% CI, 1.11-4.57). Rotavirus diarrhea
was associated (aOR, 1.25; 95% CI, 1.07-1.46) with those who received
antimicrobials prior to hospital admission and protectively associated with
drinking tap water (aOR, 0.84; 95% CI, 0.73-0.95); however, ETEC diarrhea
had protective association (aOR, 0.62; 95% CI, 0.43-0.92) with children who
received antimicrobials prior to hospital admission and was associated with
drinking tap water (aOR, 1.78; 95% CI, 1.19-2.66). Use of intravenous fluid
was associated with cholera (aOR, 10.36; 95% CI, 4.85-22.16) and had
protective association with rotavirus episodes (aOR, 0.64; 95% CI,
0.45-0.91). Conclusions Clinical presentations and host characteristics of rotavirus, ETEC, and
Vibrio cholerae diarrhea differed from each other and
the information may be helpful for clinicians for better understanding and
proper management of these children.
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Affiliation(s)
- Mohammad Habibur Rahman Sarker
- Hiroshima University, Hiroshima,
Japan
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | | | | | | | - Md Nazim Uzzaman
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Jui Das
- The University of Queensland, Brisbane,
Australia
| | - Aftab Uddin
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Shakila Banu
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Soroar Hossain Khan
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Abu SMSB Shahid
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | | | - Mohammod Jobayer Chisti
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
- Mohammod Jobayer Chisti, Nutrition and
Clinical Services Division (NCSD), 68, Shaheed Tajuddin Ahmed Sarani Mohakhali,
Dhaka 1212, Bangladesh.
| | - Abu S. G. Faruque
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal
Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
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Wang W, Ma Y, Zhou Y, Huang H, Dou W, Jiang B. Investigation into the content and formation of trihalomethanes and molecular change of dissolved organic matter from a typical water plant in south China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:4315-4328. [PMID: 33860413 DOI: 10.1007/s10653-021-00917-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
Trihalomethanes (THMs) are a class of disinfection by-products that were proved to have adverse effects to human health. Investigation into its content change and molecular composition variation of its main precursor, which is believed to be dissolved organic matter (DOM) during water purification process, can help understand the formation mechanism of THMs and optimize the processes in drinking water treatment plant (DWTP). This is of great significance to ensure the safety of urban water supply. In this study, detailed changes of THMs' content and formation potential were determined during the water purification process in summer and winter at a typical DWTP in south China. Specific molecular composition changes of DOM were also characterized by ultrahigh-resolution mass spectrometry, to comprehensively study its correlation with the formation of THMs in different water processing units and seasons. The result showed that chlorination will cause drastic changes of water quality and a sharp increase in the concentration of THMs (18.7 times in summer and 13.9 times in winter). Molecular-level characterization of DOM indicates that a range of lignin-like substance with lower O/C (< 0.5) and H/C (< 1.25) vanished and considerable amount of protein-like and tannins-like substance with higher H/C (> 1.25) and O/C (> 0.5) was formed after chlorination. Analysis of Cl-containing products demonstrated that a bulk of CHOCl1 and CHOCl2 compounds with moderate molecular weights were formed in both winter and summer. However, the newly formed CHOCl1 molecules showed a relatively higher mass weight in summer (> 500 Da) compared to winter (300-500 Da). Seasonal differences also emerged in the result of correlation between the trihalomethanes formation potential and total organic carbon. The correlation coefficient in summer (0.500) was lower than that in winter (0.843). The results suggested that the exhaustive reaction and contribution of DOM to THMs may vary in different seasons.
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Affiliation(s)
- Wei Wang
- Guangdong Provincial Key Laboratory of Emergency Test for Dangerous Chemicals, Guangzhou, 510070, China
- Institute of analysis, Guangdong Academy of Science (China National Analytical Center, Guangzhou), Guangzhou, 510070, China
| | - Yanfang Ma
- Guangdong Provincial Key Laboratory of Emergency Test for Dangerous Chemicals, Guangzhou, 510070, China
- Institute of analysis, Guangdong Academy of Science (China National Analytical Center, Guangzhou), Guangzhou, 510070, China
| | - Yibo Zhou
- Guangdong Provincial Key Laboratory of Emergency Test for Dangerous Chemicals, Guangzhou, 510070, China
- Institute of analysis, Guangdong Academy of Science (China National Analytical Center, Guangzhou), Guangzhou, 510070, China
| | - Hong Huang
- Guangdong Provincial Key Laboratory of Emergency Test for Dangerous Chemicals, Guangzhou, 510070, China
- Institute of analysis, Guangdong Academy of Science (China National Analytical Center, Guangzhou), Guangzhou, 510070, China
| | - Wenyuan Dou
- Guangdong Provincial Key Laboratory of Emergency Test for Dangerous Chemicals, Guangzhou, 510070, China.
- Institute of analysis, Guangdong Academy of Science (China National Analytical Center, Guangzhou), Guangzhou, 510070, China.
| | - Bin Jiang
- State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, China.
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Abstract
Since 1817, cholera, caused by Vibrio cholerae, has been characterized by seven distinct pandemics. The ongoing seventh pandemic (7P) began in 1961. In this study, we developed a Multilevel Genome Typing (MGT) tool for classifying the V. cholerae species with a focus on the 7P. MGT is based on multilocus sequence typing (MLST), but the concept has been expanded to include a series of MLST schemes that compare population structure from broad to fine resolutions. The V. cholerae MGT consists of eight levels, with the lowest, MGT1, composed of 7 loci and the highest, MGT8, consisting of the 7P core genome (3,759 loci). We used MGT to analyze 5,771 V. cholerae genomes. The genetic relationships revealed by lower MGT levels recapitulated previous findings of large-scale 7P transmission across the globe. Furthermore, the higher MGT levels provided an increased discriminatory power to differentiate subgroups within a national outbreak. Additionally, we demonstrated the usefulness of MGT for non-7P classification. In a large non-7P MGT1 type, MGT2 and MGT3 described continental and regional distributions, respectively. Finally, MGT described trends of 7P in virulence, and MGT2 to MGT3 sequence types (STs) grouped isolates of the same ctxB, tcpA, and ctxB-tcpA genotypes and characterized their trends over the pandemic. MGT offers a range of resolutions for typing V. cholerae. The MGT nomenclature is stable, transferable, and directly comparable between investigations. The MGT database (https://mgtdb.unsw.edu.au/) can accept and process newly submitted samples. MGT allows tracking of existing and new isolates and will be useful for understanding future spread of cholera. IMPORTANCE In 2017, the World Health Organization launched the “Ending Cholera” initiative to reduce cholera-related deaths by 90% by 2030. This strategy emphasized the importance of the speed and accessibility of newer technologies to contain outbreaks. Here, we present a new tool named Multilevel Genome Typing (MGT), which classifies isolates of the cholera-causing agent, Vibrio cholerae. MGT is a freely available online database that groups genetically similar V. cholerae isolates to quickly indicate the origins of outbreaks. We validated the MGT database retrospectively in an outbreak setting, showcasing rapid confirmation of the Nepalese origins for the 2010 Haiti outbreak. In the past 5 years, thousands of V. cholerae genomes have been submitted to the NCBI database, which underscores the importance of and need for proper genome data classification for cholera epidemiology. The V. cholerae MGT database can assist in early decision making that directly impacts controlling both the local and global spread of cholera.
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50
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Islam MT, Nasreen T, Kirchberger PC, Liang KYH, Orata FD, Johura FT, Hussain NAS, Im MS, Tarr CL, Alam M, Boucher YF. Population Analysis of Vibrio cholerae in Aquatic Reservoirs Reveals a Novel Sister Species ( Vibrio paracholerae sp. nov.) with a History of Association with Humans. Appl Environ Microbiol 2021; 87:e0042221. [PMID: 34132593 PMCID: PMC8357300 DOI: 10.1128/aem.00422-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/04/2021] [Indexed: 12/12/2022] Open
Abstract
Most efforts to understand the biology of Vibrio cholerae have focused on a single group, the pandemic-generating lineage harboring the strains responsible for all known cholera pandemics. Consequently, little is known about the diversity of this species in its native aquatic environment. To understand the differences in the V. cholerae populations inhabiting regions with a history of cholera cases and those lacking such a history, a comparative analysis of population composition was performed. Little overlap was found in lineage compositions between those in Dhaka, Bangladesh (where cholera is endemic), located in the Ganges Delta, and those in Falmouth, MA (no known history of cholera), a small coastal town on the United States east coast. The most striking difference was the presence of a group of related lineages at high abundance in Dhaka, which was completely absent from Falmouth. Phylogenomic analysis revealed that these lineages form a cluster at the base of the phylogeny for the V. cholerae species and were sufficiently differentiated genetically and phenotypically to form a novel species. A retrospective search revealed that strains from this species have been anecdotally found from around the world and were isolated as early as 1916 from a British soldier in Egypt suffering from choleraic diarrhea. In 1935, Gardner and Venkatraman unofficially referred to a member of this group as Vibrio paracholerae. In recognition of this earlier designation, we propose the name Vibrio paracholerae sp. nov. for this bacterium. Genomic analysis suggests a link with human populations for this novel species and substantial interaction with its better-known sister species. IMPORTANCE Cholera continues to remain a major public health threat around the globe. Understanding the ecology, evolution, and environmental adaptation of the causative agent (Vibrio cholerae) and tracking the emergence of novel lineages with pathogenic potential are essential to combat the problem. In this study, we investigated the population dynamics of Vibrio cholerae in an inland locality, which is known as endemic for cholera, and compared them with those of a cholera-free coastal location. We found the consistent presence of the pandemic-generating lineage of V. cholerae in Dhaka, where cholera is endemic, and an exclusive presence of a lineage phylogenetically distinct from other V. cholerae lineages. Our study suggests that this lineage represents a novel species that has pathogenic potential and a human link to its environmental abundance. The possible association with human populations and coexistence and interaction with toxigenic V. cholerae in the natural environment make this potential human pathogen an important subject for future studies.
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Affiliation(s)
| | - Tania Nasreen
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Paul C. Kirchberger
- Department of Integrative Biology, University of Texas at Austin, Austin, Texas, USA
| | - Kevin Y. H. Liang
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Fabini D. Orata
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Fatema-Tuz Johura
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nora A. S. Hussain
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Monica S. Im
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cheryl L. Tarr
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Munirul Alam
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Yann F. Boucher
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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